Lupus and Pleurisy

X-ray image of lungs with infectious pleurisy
Lupus and Pleurisy. BSIP/UIG / Getty Images

Systemic lupus erythematosus (SLE), an autoimmune disease, is truly a disease of symptoms. Its attacks on the body’s immune system and can affect everything from the skin and joints to internal organs.

Cardiopulmonary complications from SLE, those affecting the lungs specifically, are common in lupus patients. Often, lupus can trigger inflammation of the lining surrounding the lungs, the pleura, causing pain when breathing or coughing.

This condition is called pleurisy or pleuritis. It is the most common pulmonary manifestation of lupus.

Symptoms:

Pleurisy’s main symptom, however, is pain in the chest and, possibly, the shoulder, worsened by deep breathing, coughing, and movement of the chest. It can also cause a build-up of fluid in the chest, making breathing difficult and causing coughing, cyanosis (blueness of the skin from oxygen deprivation; occurring in only the most extreme cases of pleural fluid accumulation due to lupus pleuritis), shortness of breath and rapid breathing.

One might say that pleuritis announces itself by raising its voice. In other words, once symptom can be heard.

The pleura is smooth, but when affected by pleuritis, it becomes rough, rubs together, and often produces a rough, grating sound. This sound is audible through a stethoscope, and sometimes by simply putting an ear to the chest.

Besides listening for abnormal sounds, your healthcare professional will most likely also conduct a number of tests, including

  • Complete blood count,
  • Thoracentesis, an invasive procedure that calls for the removal of fluid or air from the pleural space to check for infection and other diagnostic purposes,
  • An ultrasound, and an
  • X-ray of the chest.

Treatment:

Treatment depends on the cause. For example, bacterial infections are treated with antibiotics and viral infections normally run their course without medication.

Pleurisy caused by lupus must usually run its course, but patients can manage pain with acetaminophen or anti-inflammatory drugs.

Sources:

Pleurisy. MedlinePlus. U.S. National Library of Medicine and the National Institutes of Health. April 2007.

Cardiopulmonary Disease. Lupus Foundation of America. March 2008.

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