Lupus & the Lungs

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An estimated 50% of people with lupus will develop lung disease at some point during the course of their disease. For people with lupus, symptoms like shortness of breath, chest pain – or pain in the chest area – pain in your lungs when you take a deep breath, dry cough, coughing that brings up blood or wheezing should be mentioned to your doctor.

There are typically six lung issues that might occur with SLE:
Acute Lupus Pneumonitis
Chronic Lupus Pneumonitis
Pulmonary Hypertension
Shrinking Lung Syndrome
Pulmonary Embolism

Pleuritis is the swelling or inflammation of the lining of the two layered membrane of the lung. The inflammation can cause sharp, stabbing pain when breathing. If fluid escapes the membrane the condition is called pleural effusion. Pleuritis – with or without effusion – is a defining feature of and part of the classification criteria for SLE. Pleuritis is treatable and antimalarials like Plaquenil may help prevent the condition.

Acute lupus pneumonitis is inflammation of the lung itself and is a serious condition characterized by chest pain, shortness of breath and dry cough that may bring up blood. Acute lupus pneumonitis requires immediate treatment. Even with immediate treatment, lung scarring may occur and be irreversible.

Chronic lupus pneumonitis is similar to acute lupus pneumonitis except that the symptoms accumulate over years. It’s possible to have chronic lupus pneumonitis with or without ever having had acute lupus pneumonitis. The disease often takes long to develop and consequently patients may not realize or complain about symptoms. Treatment is available however like acute lupus pneumonitis, scarring to the lungs is irreversible.

Pulmonary hypertension is a unique form of high blood pressure in which the blood vessel that carries blood from the heart to the lungs thickens and doesn’t allow the appropriate amount of blood to flow. This causes the heart to work harder and getting oxygen to your body is more difficult and as a result is reduced. There are treatments for pulmonary hypertension.

Shrinking lung syndrome is a rare lupus complication that results in a feeling of breathlessness and reduced chest expansion. Some people with shrinking lung syndrome improve with treatment.

Pulmonary embolism is when a blood clot travels to the lungs. People with lupus are more likely to develop a pulmonary embolism. The clot typically develops in the leg – symptoms of a blood clot in the leg include warmth, swelling, pain and redness around the area. The clot will travel through the bloodstream to the lung and can actually stop a person’s ability to breath. Pulmonary embolism can happen quickly, can cause lasting damage and requires emergency medical attention.

Take note of your lungs and symptoms and discuss them with your doctor. For more information, contact the Lupus Society of Illinois at [email protected] or call 800-258-7872.

Resources for this article:
Lupus Resources Institute: Breathe Easy: What to Do When Lupus Affects Your Lungs

Johns Hopkins online: Lupus Primer/How Lupus Affects the Body/Lungs

Molly’s Fund: Take My Breath Away: Lupus and the Lungs by Kelli Roseta Pulmonary Manifestations of Systemic Lupus Erythematosus by Shikha Mittoo, MD, MHS, FRCPC; Charlene D Fell, MS, MSc, FRCPC, FCCP

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