So Clara, Imai Ryosuke, Tomishima Yutaka, Nishimura Naoki
Internal Medicine, St. Luke's International Hospital, Japan.
Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan.
Intern Med. 2019 Jun 1;58(11):1617-1620. doi: 10.2169/internalmedicine.1886-18. Epub 2019 Feb 1.
We documented four cases of systemic lupus erythematosus (SLE) presenting with pleuritis as the initial disease manifestation. The diagnosis was challenging because, atypically, all patients were elderly and 3 of the 4 patients were men. Furthermore, SLE pleuritis, characterized by lymphocytic pleural effusion and high ADA activity, is difficult to differentiate from tuberculous pleurisy. A detailed physical examination, blood tests, and urinalysis are therefore indispensable to ensure an accurate diagnosis. We also reviewed the previously published case reports on SLE patients presenting with pleuritis and discussed the relevant findings.
我们记录了4例以胸膜炎为首发疾病表现的系统性红斑狼疮（SLE）病例。诊断颇具挑战性，因为所有患者均为老年人，且4例中有3例为男性，这与典型情况不同。此外，以淋巴细胞性胸腔积液和高ADA活性为特征的SLE胸膜炎难以与结核性胸膜炎相鉴别。因此，详细的体格检查、血液检查和尿液分析对于确保准确诊断必不可少。我们还回顾了此前发表的关于以胸膜炎为表现的SLE患者的病例报告，并讨论了相关发现。
