Pleuro-Pulmonary Manifestations of Systemic Lupus Erythematosus

¹ The Hospital de Enfermedades de la Nutrición, México, D. F.
² Director, Sanatorio San Angel, México, D.F.

The pleuro-pulmonary manifestations of S.L.E. stand among the most frequent of the visceral affections of this disease.

Forty-eight cases from the Instituto Nacional de Cardiologia, the Hospital de Enfermedades de la Nutrición and the Sanatorio San Angel are reviewed. In these, the diagnosis was proved by a positive L. E. cell test, which we consider specific, and/or various histologic studies, including 19 autopsies.

Symptoms, radiology and pathology of pleuro-pulmonary involvement are discussed. The lung was affected in 79 per cent of our cases; surpassed only by renal involvement.

Although respiratory symptoms and important radiologic changes were common, physical findings were usually scarce.

Three fundamental radiologic patterns were found in the pulmonary parenchyma; in seven cases a fine micronodular infiltrate; in another seven a diffuse infiltrate resembling pneumonitis, and in four, linear shadows of atelectasis. The main characteristic of these findings is the changing pattern, which is illustrated and discussed.

Hydrothorax was found by chest x-ray film in 22 cases and was important enough to be detected by physical examination in half of them.

The pathologic data at autopsy were practically non-specific, and in spite of important clinical and radiologic findings, usually little was found post-mortem. Specific lesions were found in the lungs in only three cases.

A brief correlation is attempted between the pleuro-pulmonary findings and the other clinical and laboratory data.