Most patients with systemic lupus erythematosus (SLE) have, during their illness, respiratory reached the most frequent is the pleurisy (one of the eleven diagnostic criteria recognized by the American Rheumatism Association). The respiratory events that found in the LED cover both the lung parenchyma as the pleura, the pulmonary vasculature, airways and respiratory muscles, and this alone or simultaneously. They may precede other manifestations of the LED or occur at any time during the disease. The clinical spectrum ranges from asymptomatic forms to attacks sometimes fatal. We must keep in mind that a pneumonia developing in a patient with lupus should mention first a trivial or opportunistic infection under a immunosuppressive treatment. This aspect will not be discussed in this manual, as well as pneumonia of drug.
[...] Five-year follow-up study of the prevalence and progression of pulmonary hypertension in systemic lupus erythematosus. Am Heart J 1995; 129: 510- Groen Bootsma Postma DS, Kallenberg CG. Primary pulmonary hypertension in a patient with systemic lupus erythematosus: Partial improvement with cyclophosphamide (see comments). J Rheumatol 1993; 20: 1055- Pin Fauchier Babuty Fauchier JP, Valat JP. Precapillary pulmonary hypertension dramatically improved with high doses of corticosteroids during systemic lupus erythematosus. J Rheumatol 1994; 21: 1976- Auger WR, Permpikul Moser KM. Lupus anticoagulant, heparin use, and thrombocytopenia in patients with chronic thromboembolic pulmonary hypertension: A preliminary report. [...]
[...] Pulmonary Hypertension The association between pulmonary hypertension (HTP) and LED has been known for decades and the prevalence was estimated at between 5 and 14%. However, the use of echocardiography combined with Doppler has allowed to better assess the prevalence of HTP. In a group of 36 patients with an LED and followed for five years, the prevalence of HTP (defined as systolic pulmonary artery pressure (PAPS)> 30 mmHg) increased from 14% initially to 43% at the end of follow-up. [...]
[...] "Bronchiolitis obliterans organizing pneumonia (BOOP) The BOOP is characterized by plugs of fibrous tissue in the respiratory bronchioles, alveolar canals and alveoli, usually associated with inflammation of the bronchioles and the surrounding parenchyma. The BOOP is characterized by coughing, usually with dyspnea, fever, pulmonary infiltrates and hypoxemia. It may be idiopathic or represent a stereotyped response to various attacks lung infection, toxic, or associated with inflammatory diseases (polymyositis, scleroderma, rheumatoid arthritis). Some cases reported in the literature show that BOOP may manifest during the LED or be part of initial events. [...]
[...] It does not seem to affect other respiratory muscles and is not secondary to cortisone myopathy or nerve damage phrensic. Clinically, these patients may be asymptomatic or present a severe and sometimes dyspnea usually orthopnée. In functional except restrictive syndrome, there is a decrease in inspiratory and expiratory pressures and a reduction in the DLCO to be corrected when reported in alveolar volume. On the basis of several cases reported in the literature, we can recommend treatment with corticosteroids because of 0.5 mg / kg / d in combination with theophylline and b2 agonists because of their beneficial effect on diaphragmatic function . [...]
[...] The acute lupus pneumonitis The acute lupus pneumonitis clinically expressed as pneumonia infectious disease and its prevalence is estimated at 1-4%. The occurrence of pneumonia or lupus exacerbation during pregnancy and post partum is not uncommon. Respiratory distress may occur in severe cases, sometimes refractory to immunosuppressive treatment, and lead to a fatal outcome. The acute lupus pneumonitis is characterized by a sudden start with dyspnea, cough, fever, pleuritic pain and sometimes haemoptysis. The hypoxemia is common. The radiological examination showed infiltrates acinaires uni-or bilateral predominant bases, sometimes accompanied pleu bilateral effusions. [...]
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