Pulmonary Manifestations of Systemic Lupus Erythematosus
Section snippets
Epidemiology and risk factors
Susceptibility to SLE has a genetic component, and familial clustering of cases is seen. From 5% to 12% of first-degree relatives of SLE patients will themselves develop the disease during their lifetime. Several susceptibility loci as well as specific gene polymorphisms have been identified, although the relationships are complex and vary by ethnicity.7 Not all studies of SLE-related genetic markers have looked separately at lung involvement; but among those that have, both protective
Pleural Disease
More so than in any other connective tissue disease, the pleura is often involved in patients with SLE. Approximately 30% to 50% of patients with SLE will develop symptomatic pleural inflammation over the course of their disease, and a larger number if asymptomatic effusions are included.10, 11 In 5% to 10% of patients, pleuritis is an initial manifestation of their SLE.12 The typical presentation of pleural involvement in SLE is sharp chest pain with a deep breath (pleurisy). Nonpleuritic
Summary
Pulmonary disease may complicate SLE and is an important cause of morbidity and mortality. Early detection of pulmonary disease in a patient with SLE is of importance because therapy ranges from aggressive immunosuppression for lupus pneumonitis, to anticoagulation for antiphospholipid antibody syndrome, to lowering immunosuppression while starting antimicrobial therapy in settings where infection is the culprit. Treatment strategies for pulmonary disease in SLE are based on limited data
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