lupus pneumonitis

Epidemiology

• 10% of lupus cases

Pathology

• diffuse alveolar damage
• may progress to pulmonary fibrosis &, eventually, pulmonary hypertension

Clinical manifestations

• severe dyspnea
• tachypea
• fever
• pleurisy
• cough
• basilar rales
• hypoxia
• no apparent infection

Laboratory

• thoracentesis with pleural fluid analysis if pleural effusion
  • pleural fluid is exudate by Light's criteria
• complete blood count
• serum chemistries, evidence of active lupus (see lupus)

Diagnostic procedures

• bronchoalveolar lavage may show increased leukocytes, predominantly lymphocytes Radiography
• chest X-ray
• atelectasis & pulmonary infiltrates predominantly in lower lobes
• pleural effusion in 30%
• CT of thorax
• diffuse pulmonary infiltrates in both lungs
• ground glass opacities in multiple lobes

Differential diagnosis

• pneumonia
• pulmonary alveolar hemorrhage

Management

• generally responds to glucocorticoids
• see lupus

More general terms

• systemic lupus erythematosus