Systemic lupus erythematosus (thoracic manifestations)

Last revised by Andrew Murphy on 7 Feb 2023

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Murphy A, Omar Carrim Y, et al. Systemic lupus erythematosus (thoracic manifestations). Reference article, Radiopaedia.org (Accessed on 20 Apr 2024) https://doi.org/10.53347/rID-25205

DOI:

https://doi.org/10.53347/rID-25205

Permalink:

https://radiopaedia.org/articles/25205

rID:

25205

Article created:

12 Oct 2013, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

7 Feb 2023, Andrew Murphy ◉

Disclosures:

At the time the article was last revised Andrew Murphy had no financial relationships to ineligible companies to disclose.

View Andrew Murphy's current disclosures

Revisions:

20 times, by 11 contributors - see full revision history and disclosures

Systems:

Chest, Cardiac

Tags:

cases

Synonyms:

Pulmonary manifestations on systemic lupus erythematosus
Respiratory involvement in systemic lupus erythematosus
Thoracic manifestations of SLE
Thoracic manifestations of systemic lupus erythematosus

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 ²
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 ⁹ / alveolar hemorrhage (reflecting diffuse endothelial injury)
chronic interstitial pneumonitis: may complicate 3-13% of patients
- interlobular septal thickening⁶
- pulmonary fibrosis associated with this can occur but is rare ¹
- 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 effusion⁸
- can be associated with nephritis, Libman-Sacks endocarditis and myocardial dysfunction

References

1. Keane MP, Lynch JP. Pleuropulmonary manifestations of systemic lupus erythematosus. Thorax. 2000;55 (2): 159-66. Thorax (full text) - doi:10.1136/thorax.55.2.159 - Free text at pubmed - Pubmed citation
2. Quadrelli SA, Alvarez C, Arce SC et-al. Pulmonary involvement of systemic lupus erythematosus: analysis of 90 necropsies. Lupus. 2009;18 (12): 1053-60. doi:10.1177/0961203309106601 - Pubmed citation
3. Carmier D, Marchand-Adam S, Diot P et-al. Respiratory involvement in systemic lupus erythematosus. Rev Mal Respir. 2010;27 (8): e66-78. doi:10.1016/j.rmr.2010.01.003 - Pubmed citation
4. Ciftçi E, Yalçinkaya F, Ince E et-al. Pulmonary involvement in childhood-onset systemic lupus erythematosus: a report of five cases. Rheumatology (Oxford). 2004;43 (5): 587-91. doi:10.1093/rheumatology/keh120 - Pubmed citation
5. Wang Y, Ma C, Yang J et-al. Libman-sacks endocarditis exclusively involving the tricuspid valve in a patient with systemic lupus erythematosus. J Clin Ultrasound. 2015;43 (4): . doi:10.1002/jcu.22180 - Pubmed citation
6. Fenlon HM, Doran M, Sant SM, Breatnach E. High-resolution chest CT in systemic lupus erythematosus. AJR. American journal of roentgenology. 166 (2): 301-7. doi:10.2214/ajr.166.2.8553934 - Pubmed
7. Alamoudi OS, Attar SM. Pulmonary manifestations in systemic lupus erythematosus: association with disease activity. Respirology (Carlton, Vic.). 20 (3): 474-80. doi:10.1111/resp.12473 - Pubmed
8. Weich HS, Burgess LJ, Reuter H, Brice EA, Doubell AF. Large pericardial effusions due to systemic lupus erythematosus: a report of eight cases. (2005) Lupus. 14 (6): 450-7. doi:10.1191/0961203305lu2131oa - Pubmed
9. Kazzaz NM, Coit P, Lewis EE, McCune WJ, Sawalha AH, Knight JS. Systemic lupus erythematosus complicated by diffuse alveolar haemorrhage: risk factors, therapy and survival. (2015) Lupus science & medicine. 2 (1): e000117. doi:10.1136/lupus-2015-000117 - Pubmed