Chapter 3 - Lung involvement in SLE

Abstract

Pulmonary manifestations of systemic lupus erythematosus (SLE) are quite diverse in their nature and frequency. While pleural involvement is relatively common (20%–40% of patients), other manifestations such as those involving the lung parenchyma (lupus pneumonitis, interstitial lung disease), the diaphragm (shrinking lung syndrome), or the lung vasculature (pulmonary arterial hypertension and pulmonary vasculitis) are infrequent, with the exception of pulmonary embolism which is largely associated with the antiphospholipid syndrome. Also, the risk of lung infection is increased, due to the disease itself, but mostly to the use of immunosuppressive treatments. Most SLE patients with lung involvement will present with a combination of chest pain, cough, and dyspnea, but others may be asymptomatic. Diagnosis of SLE-associated lung involvement is typically made with thoracic imaging such as chest X-ray or nowadays more commonly with high-resolution computed chest tomography (HRCT), pulmonary function tests, echocardiography, lung scintigraphy, or transthoracic ultrasound of the lung [1].