Systemic lupus erythematosus (thoracic manifestations)

Thoracic manifestations of systemic lupus erythematosus can be variable.

For a general discussion, and for links to other system specific manifestations, please refer to the article on systemic lupus erythematosus.

Pathology

Pleuropulmonary manifestations

• pleuritis: considered one of the commonest thoracic manifestations
• acute lupus pneumonitis
• diaphragmatic dysfunction and shrinking lung syndrome
• cavitating pulmonary nodules
• pulmonary hypertension
• pulmonary vasculitis
• pulmonary embolism (often due to circulating anticardiolipin antibodies)
• pulmonary hemorrhage / alveolar hemorrhage (reflecting diffuse endothelial injury)
• chronic interstitial pneumonitis: may complicate 3-13% of patients
  • interlobular septal thickening
  • pulmonary fibrosis associated with this can occur but is rare
  • parenchymal bands
  • subpleural bands
  • bronchiectasis
  • bronchial wall thickening
  • pleural thickening
• bronchiolitis obliterans (with or without organizing pneumonia)
• opportunistic pulmonary infection or drug toxicity from immunosuppressive therapy

Cardiac manifestations

• pancarditis
  • Libman-Sacks endocarditis: sterile vegetations on the mitral and aortic valves (rare)
• pericardial effusion:  can be associated with nephritis, Libman-Sacks endocarditis and myocardial dysfunction

See also

• systemic lupus erythematosus