Acute lupus pneumonitis with normal chest radiograph.
Patients with acute lupus pneumonitis (ALP) usually have hypoxemia, patchy infiltrates evidenced on a chest x-ray film, and an incomplete response to corticosteroids with high mortality. In contrast, lupus patients with a syndrome of acute reversible hypoxemia (SARH) have hypoxemia with normal chest x-ray films and a rapid response to corticosteroids. We present a case of biopsy-proven ALP with normal initial chest x-ray films, and a normal CT scan. We hypothesize that a continuum of vascular and parenchymal abnormalities may exist in the lungs of lupus patients. This case also illustrates the insensitivity of routine chest radiographs in demonstrating mild or early pneumonitis.
Susanto
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Department of Medicine, University of Texas Health Science Center at San Antonio 78284-7885, USA.
Peters
J I
JI
D000208:Acute Disease; D001706:Biopsy; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000209:etiology; D008168:Lung / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000175:diagnosis* / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed