Table 1

Acute and chronic pulmonary complications of JSLE

ComplicationsPercentage affectedInvestigationsPrognosis
Acute
 Infective pneumoniaUp to 90%CXR: consolidation
BAL: culture may isolate pathogen
Variable
 Pleuritis50–80%CXR: may show pleural effusionGood
 Thromboembolic diseaseVariableCXR: pulmonary oligaemia, peripheral wedge-shaped consolidation, may show pleural effusion
CTPA: may show pulmonary embolus
Doppler: may show venous embolus
Variable
Can progress to pulmonary hypertension
 Alveolar haemorrhage (AH)<2%Full blood count: drop in haemoglobin
CXR: patchy infiltrates at bases
BAL: blood stained, haemosiderin-laden macrophages
Mortality >50%
 Acute lupus pneumonitis (ALP)<10%CXR: patchy infiltrates at bases70–90%
Chronic
 Chronic ILD3%CXR/CT: interstitial infiltrates, ground-glass shadowing, honeycombing
PFT:↓FVC, ↓DLCO
Variable, can be slowly progressive
 Pulmonary hypertension5–14%Echocardiography: ↑right ventricular pressures, PAP >20 mmHg
PFT: stable FVC, ↓DLCO
Up to 50%
 Shrinking lung syndrome<1%CXR: ↓ lung volume, raised hemi diaphragm
PFT: ↓FVC, ↓DLCO
Good

CXR: chest radiography; BAL: bronchoalveolar lavage; CTPA: computed tomography pulmonary angiogram; PFT: pulmonary function test.