Pulmonary Manifestations of Systemic Lupus Erythematosus

Beatrice Memet; Ellen M. Ginzler

doi:10.1055/s-2007-985665

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2007; 28(4): 441-450
DOI: 10.1055/s-2007-985665

Pulmonary Manifestations of Systemic Lupus Erythematosus

Beatrice Memet¹ , Ellen M. Ginzler¹ ^, ²

¹Division of Rheumatology, State University of New York-Downstate Medical Center, Brooklyn, New York
²Department of Medicine, State University of New York-Downstate Medical Center, Brooklyn, New York

Abstract

ABSTRACT

Systemic lupus erythematosus (SLE) can affect the lung in multiple ways. All components of the respiratory system, including the pleura, pulmonary parenchyma, airways, vessels, and respiratory muscles can be involved in various degrees at some time in the disease course and contribute to its morbidity and mortality. This article reviews the clinical symptoms, imaging techniques, histopathology, prognosis, and treatment of pulmonary manifestations of SLE and the related disorder mixed connective tissue disease (MCTD), from a historical perspective and with regard to new insights into pathogenesis and therapy.

KEYWORDS

Systemic lupus erythematosus - pleuropulmonary disease - prognosis - treatment

Volltext

Referenzen

REFERENCES

1 Osler W. On the visceral manifestations of the erythema group of skin diseases. Am J Med Sci. 1904; 127 1-3
2 D'Cruz D, Khamashta M, Hughes G. Pulmonary manifestations of systemic lupus erythematosus. In: Wallace DJ, Hahn BHH Dubois' Lupus Erythematosus. Philadelphia; Lippincott, Williams and Wilkins 2002: 663-683
3 Estes D, Christian C L. The natural history of systemic lupus erythematosus by prospective analysis. Medicine. 1971; 50 85-94
4 Huang C-T, Hennigar G R, Lyons H A. Pulmonary dysfunction in with systemic lupus erythematosus. N Engl J Med. 1965; 272 288-293
5 Andonopoulos A P, Constantopoulos S H, Galanopoulou V, Drosos A A, Acritidis N C, Moutsopoulos H M. Pulmonary function of nonsmoking patients with systemic lupus erythematosus. Chest. 1988; 94 312-315
6 Groen H, ter Borg E J, Postma D S, Wouda A A, van der Mark T W, Kallenberg C G. Pulmonary function in systemic lupus erythematosus is related to distinct clinical, serologic, and nailfold capillary patterns. Am J Med. 1992; 93 619-627
7 Jonsson H, Nived O, Sturfelt G, Valind S, Jonson B. Lung function in patients with systemic lupus erythematosus and persistent chest symptoms. Br J Rheumatol. 1989; 28 492-499
8 Rolla G, Brussino L, Bertero M T, Bucca C, Converso M, Caligaris-Capio F. Respiratory function in systemic lupus erythematosus: relation with activity and severity. Lupus. 1996; 5 38-43
9 Scano G, Goti P, Duranti R, Misuri G, Emmi L, Rosi E. Control of breathing in a subset of patients with systemic lupus erythematosus. Chest. 1995; 108 759-766
10 Gibson C J, Edmonds J P, Hughes G RV. Diaphragm function and lung involvement in systemic lupus erythematosus. Am J Med. 1977; 63 926-932
11 Hardy K, Herry I, Attali V, Cadranel J, Similowsky T. Bilateral phrenic paralysis in a patient with systemic lupus erythematosus. Chest. 2001; 119 1274-1277
12 Al-Raqum H A, Uppal S S, Al-Mutairy M, Kumari R. Shrinking lung syndrome as a presenting manifestation of systemic lupus erythematosus in a female Kuwaiti. Clin Rheumatol. 2006; 25 412-414
13 Keane M P, Lynch III J P. Pleuropulmonary manifestations of systemic lupus erythematosus. Thorax. 2000; 55 159-166
14 Cervera R, Khamashta M A, Font J et al.. Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1000 patients. The European Working Party on Systemic Lupus Erythematosus. Medicine (Baltimore). 1993; 72 113-124
15 Sahn S A. The pathophysiology of pleural effusions. Annu Rev Med. 1990; 41 7-13
16 Turner-Stokes L, Haslam P, Jones M et al.. Autoantibody and idiotype profile of lung involvement in autoimmune rheumatic disease. Ann Rheum Dis. 1990; 49 160-162
17 Wiedemann H P, Matthay R A. Pulmonary manifestations of the collagen vascular diseases. Clin Chest Med. 1989; 10 677-722
18 Crestani B. The respiratory system in connective tissue disorders. Allergy. 2005; 60 715-735
19 Fenlon H M, Doran M, Sant S M, Breatnach E. High resolution chest CT in systemic lupus erythematosus. AJR Am J Roentgenol. 1996; 166 301-307
20 Susanto I, Peters J I. Acute lupus pneumonitis with normal chest radiograph. Chest. 1997; 111 1781-1783
21 Inoue T, Kanayama Y, Ohe A et al.. Immunopathologic studies of pneumonitis in systemic lupus erythematosus. Ann Intern Med. 1979; 91 30-34
22 Boulware D W, Hedgpeth M T. Lupus pneumonitis and anti-SSA(Ro) antibodies. J Rheumatol. 1989; 16 479-481
23 Mochizuki T, Aotsuka S, Satoh T. Clinical and laboratory features of lupus patients with complicating pulmonary disease. Respir Med. 1999; 93 95-101
24 Raj R, Murin S, Matthay R A, Widemann H P. Systemic lupus erythematosus in the intensive care unit. Crit Care Clin. 2002; 18 781-803
25 Isbister J P, Ralston M, Hayes J M, Wright R. Fulminant lupus pneumonitis with acute renal failure and RBC aplasia: successful management with plasmapheresis and immunosuppression. Arch Intern Med. 1981; 141 1081-1083
26 Winder A, Molad Y, Osfeld I et al.. Treatment of systemic lupus erythematosus by prolonged administration of high dose of intravenous immunoglobulin: report of 2 cases. J Rheumatol. 1993; 20 495-498
27 Eiser A R, Shanies H M. Treatment of lupus interstitial lung disease with intravenous cyclophosphamide. Arthritis Rheum. 1994; 37 428-431
28 Santos-Ocampo A S, Mandell B F, Fessler B J. Alveolar hemorrhage in systemic lupus erythematosus. Chest. 2000; 118 1083-1090
29 Haupt H M, Moore G W, Hutchins G M. The lung in systemic lupus erythematosus. Am J Med. 1981; 71 791-798
30 Zamora M R, Warner M L, Tuder R, Schwarz M I. Diffuse alveolar hemorrhage and systemic lupus erythematosus: clinical presentation, histology, survival, and outcome. Medicine. 1997; 76 192-202
31 Myers J L, Katsenstein A L. Microangiitis in lupus-induced pulmonary hemorrhage. Am J Clin Pathol. 1986; 85 552-556
32 Onomura K, Nakata H, Tanakaya Y, Tsuda T. Pulmonary hemorrhage in patients with systemic lupus erythematosus. J Thorac Imaging. 1991; 6 57-61
33 Orens J B, Martinez F J, Lynch J P. Pleuropulmonary manifestations of systemic lupus erythematosus. Rheum Dis Clin North Am. 1994; 20 159-192
34 Dweik R A, Arroliga A C, Cash G M. Alveolar hemorrhage in patients with rheumatic disease. Rheum Dis Clin North Am. 1997; 23 395-410
35 Erickson R W, Franklin W A, Emlen W. Treatment of hemorrhagic lupus pneumonitis with plasmapheresis. Semin Arthritis Rheum. 1994; 24 114-123
36 Sant S M, Doran M, Fenelon H M, Breatnach E S. Pleuropulmonary abnormalities in patients with systemic lupus erythematous: assessment with high resolution computed tomography, chest radiography and pulmonary function tests. Clin Exp Rheumatol. 1997; 15 507-513
37 Bankier A A, Kiener H P, Wiesmayr M N et al.. Discrete lung involvement in systemic lupus erythematosus: CT assessment. Radiology. 1995; 196 835-840
38 Ooi G C, Ngan H, Peh W CG et al.. Systemic lupus erythematosus patients with respiratory symptoms: the value of HRCT. Clin Radiol. 1997; 52 775-781
39 Jacobsen S, Petersen J, Ullman S et al.. A multicenter study of 513 Danish patients with systemic lupus erythematosus, I: Disease manifestations and analysis of clinical subsets. Clin Rheumatol. 1998; 17 468-477
40 Weinrib L, Sharma O P, Quismorio Jr F P. A long-term study of interstitial lung disease in systemic lupus erythematosus. Semin Arthritis Rheum. 1990; 20 48-56
41 Colby T V. Pulmonary pathology in patients with systemic autoimmune diseases. Clin Chest Med. 1998; 19 587-612
42 Swigris J J, Olson A L, Fischer A et al.. Mycophenolate mofetil is safe, well tolerated, and preserves lung function in patients with connective tissue-related interstitial lung disease. Chest. 2006; 130 30-36
43 Langford C A, Waes C. Upper airway obstruction in the rheumatic diseases: life-threatening complications of autoimmune disease. Rheum Dis Clin North Am. 1997; 23 345-363
44 Smith G A, Ward P H, Berci G. Laryngeal lupus erythematosus. J Laryngol Otol. 1978; 92 67-73
45 Teitel A D, MacKenzie C R, Stern R et al.. laryngeal involvement in systemic lupus erythematosus. Semin Arthritis Rheum. 1992; 22 203-214
46 Curley J W, Byron M A, Bates G J. Cryco-arytenoid joint involvement in acute systemic lupus erythematosus. J Otol 1986; 100 727-732
47 Nossent J, Berend K. Cricoarytenoiditis in systemic lupus erythematosus. Scand J Rheumatol. 1998; 27 237-238
48 Karim A, Shahid A, Siddiqui R et al.. Severe upper airway obstruction from crycoarytenoiditis as the sole presenting manifestation of a systemic lupus erythematosus flare. Chest. 2002; 121 990-993
49 Godeau B, Cormier C, Menkes C J. Bronchiolitis obliterans in systemic lupus erythematosus: beneficial effect of intravenous cyclophosphamide. Ann Rheum Dis. 1991; 50 956-958
50 Hinderliter A L, Willis P W, Barst R J et al.. Effects of long-term infusion of prostacyclin (epoprostenol) on echocardiographic measures of right ventricular structure and function in primary pulmonary hypertension: Primary Pulmonary Hypertension Study Group. Circulation. 1997; 95 1479-1486
51 Winslow T M, Ossipov M A, Fazio G P et al.. The left ventricle in systemic lupus erythematosus: initial observations and a five-year follow-up in a university medical center population. Am Heart J. 1993; 125 1117-1122
52 Hosoda Y, Suzuki Y, Takano M et al.. Mixed connective tissue disease with pulmonary hypertension: a clinical and pathological study. J Rheumatol. 1987; 14 826-830
53 Sullivan W D, Hurst D J, Harmon C E et al.. A prospective evaluation emphasizing pulmonary involvement in patients with mixed connective tissue disease. Medicine. 1984; 63 92-107
54 Chung S M, Lee C K, Lee E Y, Yoo B, Lee S D, Moon H B. Clinical aspects of pulmonary hypertension in patients with idiopathic pulmonary arterial hypertension. Clin Rheumatol. 2006; 25 866-872
55 Burdt M A, Hoffman R W, Deutscher S L et al.. Long-term outcome in mixed connective tissue disease: longitudinal clinical and serologic findings. Arthritis Rheum. 1999; 42 899-909
56 Quismorio Jr F P, Shjarma O, Koss M et al.. Immunopathologic and clinical studies in clinical studies in pulmonary hypertension associated with systemic lupus erythematosus. Semin Arthritis Rheum. 1984; 13 349-359
57 Grunig E, Janssen B, Mereles D et al.. Abnormal pulmonary artery pressure response in asymptomatic carriers of primary pulmonary hypertension gene. Circulation. 2000; 102 1145-1150
58 McGoon M, Gutterman D, Steen V et al.. Screening, early detection, and diagnosis of pulmonary artery hypertension. Chest. 2004; 126 14S-34S
59 Miyamoto S, Nagaya N, Satoh T et al.. Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension: comparison with cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2000; 161 487-492
60 Humbert M, Sitbon O, Simonneau G. Treatment of pulmonary artery hypertension. N Engl J Med. 2004; 351 1425-1436
61 Simonson J S, Schiller N B, Petri M et al.. Pulmonary hypertension in systemic lupus erythematosus. J Rheumatol. 1989; 16 918-925
62 Asherson R A, Higenbottom T W, Dihn Xuan A T et al.. Pulmonary hypertension in a lupus clinic: experience with twenty four patients. J Rheumatol. 1990; 17 1292-1298
63 Christman B W, McPherson C D, Newman J H et al.. An imbalance between the excretion of thromboxane and prostacyclin metabolites in pulmonary hypertension. 1992; 327 70-75
64 Giaid A, Yanagisawa M, Langleben D et al.. Expression of endothelin-1 in the lungs of patients with pulmonary hypertension. 1993; 328 1732-1739
65 Cella G, Belloto F, Tona F et al.. Plasma markers of endothelial dysfunction in pulmonary hypertension. Chest. 2001; 120 1226-1230
66 McLaughlin V V, Presberg K W, Doyle R L et al.. Prognosis of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest. 2004; 126 78S-92S
67 Galiè N, Ghofrani H A, Torbicki A et al.. Sildenafil citrate therapy for pulmonary arterial hypertension. N Engl J Med. 2005; 353 2148-2157
68 Fuster V, Steele P M, Edwards W D, Gersh B J, McGoon M D, Frye R L. Primary pulmonary hypertension: natural history and the importance of thrombosis. Circulation. 1984; 70 580-587
69 Abu-Shakra M, Gladman D D, Urowits M B et al.. Anticardiolipin antibodies in systemic lupus erythematosus: clinical and laboratory correlations. Am J Med. 1995; 99 624-628
70 Asherson R A, Cervera R, Piette J C et al.. Catastrophic antiphospholipid syndrome: clinical and laboratory features of 50 patients. Medicine. 1998; 77 195-207
71 Hoffbrand B I, Beck E R. Unexplained dyspnea and shrinking lungs in systemic lupus erythematosus. BMJ. 1965; 1 1273-1277
72 Rubin L A, Urowitz M B. Shrinking lung syndrome in SLE: a clinical pathologic study. J Rheumatol. 1983; 10 973-976
73 Laroche C M, Mulvey D A, Hawkins P N et al.. Diaphragm strength in the shrinking lung syndrome of with systemic lupus erythematosus. Q J Med. 1989; 71 429-439
74 Warrington K J, Moder K G, Brutinel W M. The shrinking lungs syndrome in systemic lupus erythematosus. Mayo Clin Proc. 2000; 75 467-472
75 Abramson S B, Dobro J, Eberle M A et al.. Acute reversible hypoxemia in systemic lupus erythematosus. Ann Intern Med. 1991; 114 941-947
76 Kim W U, Kim S I, Yoo W H et al.. Adult respiratory distress syndrome in systemic lupus erythematosus: causes and prognostic factors: a single center, retrospective study. Lupus. 1999; 8 552-557

Ellen M GinzlerM.D.

State University of New York-Downstate Medical Center

450 Clarkson Ave., Box 42, Brooklyn, NY 11203

eMail: ellen.ginzler@downstate.edu