Systemic lupus erythematosus (SLE), commonly known as lupus, is a chronic condition that can affect various body systems. Pleurisy refers to the inflammation of the pleura, the thin, double-layered membrane surrounding the lungs and lining the chest cavity. The connection between these two conditions is well-established, with lupus often leading to pleurisy. This article explores how lupus causes pleurisy, how to recognize its symptoms, and the typical approaches to diagnosis and treatment.
The Lupus-Pleurisy Connection
Lupus is an autoimmune disease, meaning the body’s immune system mistakenly attacks its own healthy tissues. In the context of pleurisy, this immune system malfunction targets the pleura, leading to inflammation. The medical term for this specific inflammation is lupus pleuritis or serositis. When the pleura becomes inflamed, its normally smooth surfaces can become rough. This roughness causes friction when the lungs expand and contract during breathing, leading to discomfort. Pleurisy is a common complication for individuals with lupus, affecting a significant portion of patients. Approximately 43% to 60% of people with lupus experience pleurisy at some point.
Recognizing Pleurisy in Lupus
Pleurisy in individuals with lupus often presents with characteristic symptoms related to the inflammation of the lung lining:
A sharp, stabbing chest pain, often localized to one side of the chest and potentially radiating to the shoulders or back. This pain worsens with deep breaths, coughing, or sneezing.
Shortness of breath, as chest pain can make it difficult to take full, deep breaths.
A dry or persistent cough, especially if fluid accumulates in the pleural space.
Chest tenderness.
Fever, particularly during a lupus flare.
Diagnosis and Treatment Approaches
Diagnosis involves a comprehensive approach, combining clinical evaluation, medical history, and various tests. Providers assess symptoms and conduct a physical exam.
Diagnostic Methods
Imaging tests: Chest X-ray, CT scan, or ultrasound visualize the lungs and pleural space, detecting fluid accumulation (pleural effusion).
Blood tests: Assess inflammation markers (C-reactive protein, erythrocyte sedimentation rate) and lupus-specific antibodies (antinuclear antibodies, anti-double-stranded DNA) to confirm lupus activity.
Thoracentesis: If pleural effusion is present, this procedure collects a fluid sample for analysis to determine the cause of inflammation.
Treatment for lupus-related pleurisy focuses on managing the underlying lupus and alleviating symptoms.
Treatment Options
Nonsteroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen, are often the initial treatment to reduce pain and inflammation.
Corticosteroids: Like prednisone, may be prescribed if NSAIDs are insufficient, as these anti-inflammatory medications can quickly reduce lupus flares.
Immunosuppressive medications: For severe or persistent cases, disease-modifying antirheumatic drugs (DMARDs) (e.g., hydroxychloroquine, azathioprine, mycophenolate mofetil) may be necessary to control immune system activity.