Health Questions and Answers

Question: What are the pulmonary manifestations of lupus?


Pulmonary involvement is fairly common in lupus and usually takes the form of pleurisy or pleural effusion. Up to 60% of patients may have pleuritic pain over the course of their illness. 
Effusions can be either transudative or exudative and in rare cases are the presenting feature. The so-called shrinking lung syndrome describes dyspnea associated with diaphragmatic dysfunction, probably secondary to chronic pleural scarring. Pulmonary parenchymal involvement or lupus pneumonitis has been described, as have pulmonary hemorrhage, pulmonary emboli, and pulmonary hypertension. Emboli and hypertension are more common when phospholipid antibodies are also present.

Reference: Harris ED, Budd RC, Firestein GS, et al (eds): Kelley’s Textbook of Rheumatology, 7th ed. Philadelphia, W.B. Saunders, 2005.

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