La Van T, Teves Kathleen, Sandhu Vaneet K
Internal Medicine, University of California, Riverside, CA, USA.
Rheumatology, Loma Linda University Medical Center, Loma Linda, CA, USA.
Oxf Med Case Reports. 2017 Oct 10;2017(10):omx064. doi: 10.1093/omcr/omx064. eCollection 2017 Oct.
Pulmonary manifestations of systemic lupus erythematosus (SLE) include, but are not limited to, pneumonia, interstitial pneumonitis, atelectasis and pleural effusion. Cavitary lung lesions are rarely associated with SLE. We present herein the case of a female patient with SLE and lupus nephritis who presented to the hospital with respiratory failure, rash and arthralgias. She was found to have a cavitary lung lesion most concerning for infection. However, despite an extensive inpatient antibiotic course, her symptoms persisted. After a collaborative effort between the primary team, pulmonology, infectious disease and rheumatology, she was placed on systemic glucocorticoid therapy, which resolved not only her respiratory failure, but also her cavitary lung lesion on subsequent follow-up with imaging. The dilemma of management in such cases will be discussed in addition to a review of previously reported cases.
系统性红斑狼疮（SLE）的肺部表现包括但不限于肺炎、间质性肺炎、肺不张和胸腔积液。空洞性肺部病变很少与SLE相关。我们在此介绍一例患有SLE和狼疮性肾炎的女性患者，她因呼吸衰竭、皮疹和关节痛入院。她被发现有一个高度怀疑感染的空洞性肺部病变。然而，尽管接受了广泛的住院抗生素治疗，她的症状仍持续存在。经过初级团队、肺病科、传染病科和风湿病科的共同努力，她接受了全身糖皮质激素治疗，这不仅解决了她的呼吸衰竭问题，而且在后续影像学随访中，她的空洞性肺部病变也消失了。除了回顾先前报道的病例外，还将讨论此类病例的管理困境。
