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