Systemic lupus erythematosus (thoracic manifestations)

Last revised by Arlene Campos on 14 Jun 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Campos A, Knipe H, et al. Systemic lupus erythematosus (thoracic manifestations). Reference article, Radiopaedia.org (Accessed on 04 Jul 2024) https://doi.org/10.53347/rID-25205

DOI:

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

Permalink:

https://radiopaedia.org/articles/25205?iframe=true

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:

14 Jun 2024, Arlene Campos ◉

Disclosures:

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

View Arlene Campos's current disclosures

Revisions:

22 times, by 12 contributors - see full revision history and disclosures

Systems:

Chest, Cardiac

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 (SLE) can be variable.

Please refer to the main article on systemic lupus erythematosus for a general discussion and links to other system-specific manifestations.

Pathology

Pleuropulmonary manifestations

pleuritis: considered one of the commonest thoracic manifestations ²
acute lupus pneumonitis ^ref
diaphragmatic dysfunction and shrinking lung syndrome^ref
cavitating pulmonary nodules^ref
pulmonary hypertension^ref
pulmonary vasculitis^ref
pulmonary embolism: often due to circulating anticardiolipin antibodies ^ref
pulmonary hemorrhage ⁹ / alveolar hemorrhage: reflecting diffuse endothelial injury^ref
chronic interstitial pneumonitis: may complicate ~7.5% (range 3-13%) of patients
- interlobular septal thickening⁶
- pulmonary fibrosis associated with this can occur but is rare ¹
- parenchymal bands ^ref
- subpleural bands^ref
- bronchiectasis^ref
- bronchial wall thickening^ref
- pleural thickening^ref
obliterative bronchiolitis (with or without organizing pneumonia)^ref
opportunistic pulmonary infection or drug toxicity from immunosuppressive therapy^ref

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 dysfunction⁸

References

1. Keane M & Lynch J. Pleuropulmonary Manifestations of Systemic Lupus Erythematosus. Thorax. 2000;55(2):159-66. doi:10.1136/thorax.55.2.159 - Pubmed
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 N, Coit P, Lewis E, McCune W, Sawalha A, Knight J. Systemic Lupus Erythematosus Complicated by Diffuse Alveolar Haemorrhage: Risk Factors, Therapy and Survival. Lupus Sci Med. 2015;2(1):e000117. doi:10.1136/lupus-2015-000117 - Pubmed

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