"Air in lupus": spontaneous pneumothorax in systematic lupus erythematosus : a case report

Publication Date

2015

Document Type

Research

Abstract

Systematic Lupus Erythematosus (SLE) frequently involves the pulmonary system commonly pleurisy in 17 to 60% of cases. However, the development of spontaneous pneumothorax in SLE is a rare occurrence, with around 10 cases reported at the present time. A case of a 23-year-old Filipino, female, with SLE for 6 years and is admitted thrice for treatment of pulmonary infection and recurrent serositis is reported. She is treated with glucocorticoid and cyclophosphamide pulse therapy. The treatment may have cause immunosuppression that leads to pulmonary infections which is thought to cause the spontaneous pneumothorax. Her pneumothorax is resolved with immediate chest tube insertion, aggressive antibiotics and chemical pleurodesis. Unfortunately, patient continually have flare up of SLE, leading to cerebritis which is attributed to be the cause of her demise. Ten case reports from 1992 to 2015 are reviewed. All of these 10 cases have underlying pulmonary lesion. Of these, three are males; only one does not receive steroid and cyclophosphamide pulse therapy; only two cases are not in SLE flare; and four of them die. This case report adds to literature a rare case of Spontaneous Pneumothorax in Systemic Lupus Erythematosus. This may help for early recognition of factors that may lead to the development of spontaneous pneumothorax. Patient must generally control the systemic symptoms and flare of SLE.

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