Thoracic involvement of systemic lupus erythematosus: Clinical, pathologic, and radiologic findings

Thoracic involvement occurs more frequently in systemic lupus erythematosus than in any other connective tissue diseases, and more than half of patien ts with the disease suffer from the involvement. Primary intrathoracic mani festations include pleural disease (effusions and/or thickening), acute lup us pneumonitis, subacute interstitial lung disease including bronchiolitis obliterans organizing pneumonia and nonspecific interstitial pneumonia with fibrosis, chronic interstitial lung disease of usual interstitial pneumoni a, pulmonary hemorrhage, pulmonary vascular disease, small airway disease o f bronchiolitis obliterans, and pulmonary arterial hypertension. Secondary intrathoracic manifestations include atelectasis due to diaphragmatic dysfu nction, opportunistic pneumonia, drug and oxygen toxicity, aspiration, and pleuropulmonary consequences of cardiac and renal failure.