20th February 2025

Systemic lupus erythematosus

As in RA, SLE may affect the lung in multiple ways. We will focus on interstitial involvement: diffuse ILD and acute lupus pneumonitis.

Diffuse ILD occurs in the majority of patients but is often asymptomatic.

Acute lupus pneumonitis can result in very severe disease with features such as cough, dyspnoea, fever, pain and hypoxia. Examination reveals widespread crepitations. Widespread infiltrates may be seen on CXR.

Management is with steroids and cytotoxic drugs. It can later develop into chronic pneumonitis.