title: A retrospective study of pulmonary infarction in patients with systemic lupus erythematosus from southern Taiwan.
abstract: Since large-scale reports of pulmonary infarction in systemic lupus erythematosus (SLE) are limited, a retrospective study was performed for this manifestation in 773 hospitalized patients in southern Taiwan from 1999 to 2009. Pulmonary infarction was defined as the presence of pulmonary embolism, persistent pulmonary infiltrates, and characteristic clinical symptoms. Demographic, clinical, laboratory, and radiological images data were analyzed. There were 12 patients with pulmonary embolism and 9 of them had antiphospholipid syndrome (APS). Six patients (19 to 53 years, average 38.2 ± 12.6) with 9 episodes of lung infarction were identified. All cases were APS and four episodes had coincidental venous thromboembolism. There were four episodes of bilateral infarction and seven episodes of larger central pulmonary artery embolism. Heparin therapy was routinely prescribed and thrombolytic agents were added in two episodes. Successful recovery was noted in all patients. In conclusion, there was a 0.8% incidence of pulmonary infarction in patients with SLE, all with the risk factor of APS. Differentiation between pulmonary infarction and pneumonia in lupus patients should be made; they have similar chest radiography with lung consolidation but require a different clinical approach in management. Although this report is a retrospective study with relatively small numbers of lupus patients with lung infarcts, our observation might provide beneficial information on the clinical features and radiological presentations during the disease evolution of pulmonary infarction in SLE with APS.
authors.affiliation: Section of Rheumatology and Immunology, Department of Internal Medicine, National Cheng Kung University Hospital and Dou-Liou Branch, Tainan, Taiwan-Republic of China.
authors.forename: C T
authors.initials: CT
authors.lastname: Weng
authors.forename: T J
authors.initials: TJ
authors.lastname: Chung
authors.forename: M F
authors.initials: MF
authors.lastname: Liu
authors.forename: M Y
authors.initials: MY
authors.lastname: Weng
authors.forename: C H
authors.initials: CH
authors.lastname: Lee
authors.forename: J Y
authors.initials: JY
authors.lastname: Chen
authors.forename: A B
authors.initials: AB
authors.lastname: Wu
authors.forename: B W
authors.initials: BW
authors.lastname: Lin
authors.forename: C Y
authors.initials: CY
authors.lastname: Luo
authors.forename: S C
authors.initials: SC
authors.lastname: Hsu
authors.forename: B F
authors.initials: BF
authors.lastname: Lee
authors.forename: H M
authors.initials: HM
authors.lastname: Tsai
authors.forename: S C
authors.initials: SC
authors.lastname: Chao
authors.forename: J Y
authors.initials: JY
authors.lastname: Wang
authors.forename: T Y
authors.initials: TY
authors.lastname: Chen
authors.forename: C W
authors.initials: CW
authors.lastname: Chen
authors.forename: H Y
authors.initials: HY
authors.lastname: Chang
authors.forename: C R
authors.initials: CR
authors.lastname: Wang
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D054060:Pulmonary Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D013624:Taiwan; D014057:Tomography, X-Ray Computed; D055815:Young Adult