title: Spontaneous pneumomediastinum and subcutaneous emphysema in systemic lupus erythematosus.
abstract: We report a case of a 29-year-old woman who is known to have systemic lupus erythematosus and idiopathic interstitial pneumonia; she presented with a 1-day history of substernal chest pain and increasing shortness of breath. On examination, she was found breathless, but was not distressed or afebrile or normotensive. Auscultation of the heart revealed a positive Hamman's sign. There was chest-wall crepitus, and auscultation of the lung showed bilateral crepitations. Full blood count and biochemical profile were unremarkable. Chest x-ray showed signs of idiopathic interstitial pneumonia in addition to pneumomediastinum (linear band of air within mediastinal planes and continuous diaphragm sign) and chest-wall subcutaneous emphysema. She was treated with high-concentration oxygen. A repeat chest x-ray 5 days later showed complete resolution of the pneumomediastinum and subcutaneous emphysema, but signs of idiopathic interstitial pneumonia continued to persist.
authors: Department of Medicine, University of Khartoum, Khartoum, Sudan. drahahmed@hotmail.com
authors: AlaEldin H
authors: AH
authors: Ahmed
authors: Elrasheid A
authors: EA
authors: Awouda
mesh_terms: D000208:Acute Disease; D000328:Adult; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000000981:diagnostic imaging; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D013902:Radiography, Thoracic / Q000379:methods; D035583:Rare Diseases; D018570:Risk Assessment; D012720:Severity of Illness Index; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology