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(Chest. 2001;119:1274-1277.)
© 2001 American College of Chest Physicians

Bilateral Phrenic Paralysis in a Patient With Systemic Lupus Erythematosus*

Karen Hardy, MD, FCCP; Isabelle Herry, MD; Valérie Attali, MD; Jacques Cadranel, MD, PhD and Thomas Similowski, MD, PhD

* From the Service de Pneumologie (Dr. Hardy), Centre Hospitalier le Raincy-Montfermeil; Service de Pneumologie (Drs. Herry and Cadranel), Hôpital Tenon; Service de Pneumologie (Dr. Attali), Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris; and UPRES EA 2397 (Dr. Similowski), Université Pierre et Marie Curie, Paris VI, France.

Correspondence to: Thomas Similowski, MD, PhD, Laboratoire de Physiopathologie Respiratoire, Service de Pneumologie et de Réanimation Groupe Hospitalier Pitié-Salpêtrière, 47–83, Bd de l’Hôpital, 75651 Paris Cedex 13, France; e-mail: thomas.similowski{at}psl.ap-hop-paris.fr

Respiratory manifestations of systemic lupus erythematosus (SLE) are frequent. They include respiratory muscle abnormalities, which have been implicated in the pathogenesis of the "shrinking lung syndrome" (SLS). We report the case of a patient with this syndrome, in whom diaphragmatic paralysis due to demyelinating phrenic lesions was diagnosed at the same time as SLE. Follow-up studies showed a favorable clinical and diaphragmatic outcome with corticosteroid therapy, but little change in spirometry. It is concluded that severe diaphragm palsy is possibly due to phrenic nerve lesions in SLE, and that the link between diaphragm dysfunction and the SLS is probably not a straightforward one.

Key Words: diaphragm • magnetic stimulation • phrenic nerve • respiratory muscles • respiratory paralysis • systemic lupus erythematosus




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