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 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 thickening ⁶

  • 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 effusion ⁸

  • can be associated with nephritis, Libman-Sacks endocarditis and myocardial dysfunction

See also

• systemic lupus erythematosus