Cavitary pulmonary lesions in systemic lupus erythematosus: an unusual manifestation

Authors

  • Reza Lotfi Radiology Department, College of Medicine, Guilan University of Medical Sciences,Rasht, Iran.

Keywords:

cavitary pulmonary lesion, systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown pathogenesis. The frequency of SLE with cavitary lesion manifestation is very rare and is thought to be due to infection or pulmonary embolism. A 19-year-old female diagnosed with SLE complicated by lupus nephritis and cavitary pulmonary lesion is presented in this case report. Other diseases that can lead to such lesions were ruled out in the patient. The patient improved briefly after the initiation of immunosuppressive therapy, but was unresponsive to supportive treatment due to pneumothorax. Pneumothorax is caused by cavitary lesions and possibly bronchopleural fistulas – these later caused respiratory distress and death. The patient did not show any improvement in the lesions after the initiation of immunosuppressive therapy. This case report suggests that the differential diagnosis of cavitary lung lesions should include SLE.

References

Mediwake R, Bois RMD. The lung in systemic lupus erythematosus. In: Tsokos, GC, Gordon C, andSmolen JS, (eds). Systemic lupus erythematosus: a companion to Rheumatology, (First Edition).Philadelphia. Elsevier. 2007:374-81.http://dx.doi.org/10.1016/B978-0-323-04434-9.50044-02.Watanabe R, Fujii H, Shirai T, Saito S, Hatakeyama A, Sugimura K, et al. Successful use of intensiveimmunosuppressive therapy for treating simultaneously occurring cerebral lesions and pulmonary arterialhypertension in a patient with systemic lupus erythematosus. Intern Med. 2014; 53(6):627-31. PMID:24633036.http://dx.doi.org/10.2169/internalmedicine.53.05143.Meng Z, Shi ZR, Tan GZ, Yin J, Wu J, Mi XB, et al. The association of anti-annexin1antibodies with theoccurrence of skin lesions in systemic lupus erythematosus. Lupus. 2014; 23(2):183-7. PMID: 24300781.http://dx.doi.org/10.1177/09612033135138204.Torok N, Abu Malouh A, KasmaniR, Abusamieh M. Cavitary lung lesions in systemic lupus: an unusualpresentation. Lupus. 2010; 19(8):993-6. PMID: 20410152.http://dx.doi.org/10.1177/09612033103657165.Maden E, Teke T, Uzun K. Cavitary pulmonary lesion due to systemic lupus erythematosus: An unusualmanifestation. Pak J Med Sci. 2011; 27(3):711-13.6.Ryu JH, Swensen SJ. Cystic and cavitary lung diseases: focal and diffuse. Mayo Clinic proceedings. 2003;78(6):744-52. PMID: 12934786.http://dx.doi.org/10.4065/78.6.7447.Kondo Y, Umegaki N, Terao M, Murota H, Kimura T, Katayama I. A case of generalized acanthosisnigricans with positive lupus erythematosus-related autoantibodies and antimicrosomal antibody:autoimmune acanthosis nigricans? Case Rep Dermatol. 2012; 4(1):85-91. PMID: 22649336.http://dx.doi.org/10.1159/0003377518.Webb WR, Gamsu G. Cavitary pulmonary nodules with systemic lupus erythematosus: differentialdiagnosis. Am J Roentgenl. 1981; 136(1):27-31. PMID: 6779577.http://dx.doi.org/10.2214/ajr.136.1.279.Najjar M, Siddiqui AK, Rossoff L, Cohen RI. Cavitary lung masses in SLE patients: an unusualmanifestation of CMV infection. Eur Respir J. 2004; 24(1):182-4. PMID: 15293622.http://dx.doi.org/10.1183/09031936.04.0011260310.Azuma N, Hashimoto N, Yasumitsu A, Fukuoka K, Yokoyama K, Sawada H, et al. CMV infectionpresenting as a cavitary lung lesion in a patient with systemic lupus erythematosus receivingimmunosuppressive therapy. Intern Med. 2009; 48(24):2145-9. PMID: 20009410.http://dx.doi.org/10.2169/internalmedicine.48.2495.

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Published

2022-03-08