Spontaneous pneumothorax secondary to acute lupus pneumonitis: one case report and literature review_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

CHENG Yusheng ^1,2 , DAI Shanlin ¹ , CHE Nan ³ ,  CHEN Xuesong ¹

1. Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangshu 210029, P. R. China;
2. Department of Respiratory Medicine, Yi Ji Shan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P. R. China;
3. Department of Rheumatology and Immunology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangshu 210029, P. R. China;

Corresponding author：

CHEN Xuesong, Email: lancetchen@163.com

Keywords：

Systemic lupus erythematosus; Lupus pneumonitis; Pneumothorax

DOI：

10.7507/1671-6205.201704011

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Objective To investigate the clinical characteristics of spontaneous pneumothorax secondary to systemic lupus erythematosus (SLE). Methods A case of spontaneous pneumothorax secondary to SLE was reported and related literatures were reviewed. Results A female patient, 26 years old, complaining of repeated fever for 3 months, chest tightness and shortness of breath more than 10 days, was hospitalized in December 2016. After admission, the patient was diagnosed as acute lupus pneumonia and received glucocorticoid, cyclophosphamide and plasma exchange therapy. Sudden right chest pain happened during hospitalization. Bedside chest CT showed right pneumothorax. After closed thoracic drainage, the syndrome of the patient was improved. A total of 14 patients were reviewd but 2 patients were excluded because of incomplete data. The left patients included 9 females and 3 males. The mean age was (28.0±11.9) years. Clinical manifestations of spontaneous pneumothorax secondary to SLE were sudden chest tightness and shortness of breath accompanied by subpleural lung cavity and vesicular changes. The majority of patients could be cured with drainage. Conclusions Pneumothorax secondary to SLE is rare which is associated with the rupture of cavity and cyst in pulmonary secondary to SLE. Majority of patients with pneumothorax could be cured after closed thoracic drainage.

Citation： CHENG Yusheng, DAI Shanlin, CHE Nan, CHEN Xuesong. Spontaneous pneumothorax secondary to acute lupus pneumonitis: one case report and literature review. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(6): 606-609. doi: 10.7507/1671-6205.201704011 Copy

1.	中华医学会风湿病分会. 系统性红斑狼疮诊断及治疗指南. 中华风湿病学杂志, 2010, 14: 342-346.
2.	Dalili AR, Lotfi R, Mousavi SM. Cavitary pulmonary lesions in systemic lupus erythematosus: an unusual manifestation. Electron Physician, 2014, 6(3): 868-871.
3.	Pamuk ON, Pamuk GE, Barutcu E, et al. The development of pulmonary aspergillosis and pneumothorax in a patient with neutropenic systemic lupus erythematosus and successful treatment of the first case. BMJ Case Rep, 2014. pii: bcr2013200818.
4.	Tanaka N, Kusunoki Y, Kaneko K, et al. Systemic lupus erythematosus complicated by recurrent pneumothorax: Case report and literature review. Nihon Rinsho Meneki Gakkai Kaishi, 2010, 33: 162-168.
5.	Maeda R, Isowa N, Miura H, et al. Systemic lupus erythematosus with multiple lung cysts. Interact Cardiovasc Thorac Surg, 2009, 8: 701-702.
6.	Wilhelm M, Van Why SK. Pneumothoraces complicating systemic lupus erythematosus with nephritis. Pediatr Nephrol, 2002, 17: 261-263.
7.	Yen JH, Tsai WC, Ou TT, et al. Systemic lupus erythematosus complicated by recurrent spontaneous pneumothorax--a case report. Kaohsiung J Med Sci, 2001, 17(10): 540-544.
8.	黄华瑞, 杨虎天. 系统性红斑狼疮并发自发性纵隔气肿及气胸一例. 中华内科杂志, 2000, 39: 177.
9.	Nishitsuji M, Nakamura H, Saito K, et al. A case of systemic lupus erythematodes with hemosputum and pneumothorax probably resulting from pulmonary infarction and pulmonary angitis. Nihon Kokyuki Gakkai Zasshi, 1998, 36: 71-76.
10.	Paira SO, Roverano S. Bilateral pneumothorax and mediastinal emphysema in systemic lupus erythematosus. Clin Rheumatol, 1992, 11: 571-573.
11.	Jay MS, Jerath R, Van Derzalm T, et al. Pneumothorax in an adolescent with fulminant systemic lupus erythematosus. J Adolesc Health Care, 1984, 5: 142-144.
12.	Passero FC, Myers AR. Hemopneumothorax in systemic lupus erythematosus. J Rheumatol, 1980, 7: 183-186.
13.	Richards AJ, Talbot IC, Swinson DR, et al. Diffuse pulmonary fibrosis and bilateral pneumothoraces in systemic lupus erythematosus. Postgrad Med J, 1975, 51: 851-855.
14.	Sawkar LA, Easom HF. Recurrent spontaneous pneumothoraces in systemic lupus erythematosus. Chest, 1971, 60: 604-605.
15.	蔡柏蔷, 李龙芸, 主编. 协和呼吸病学(第 2 版). 北京: 中国协和医科大学出版社, 2011, 1868-1873.
16.	Bouros D, Pneumatikos I, Tzouvelekis A. Pleural involvement in systemic autoimmune disorders. Respiration, 2008, 75: 361-371.
17.	Singh JA, Hossain A, Kotb A, et al. Risk of serious infections with immunosuppressive drugs and glucocorticoids for lupus nephritis: a systematic review and network meta-analysis. BMC Med, 2016, 14: 137.
18.	Hsu CW, Sun SF. Iatrogenic pneumothorax related to mechanical ventilation. World J Crit Care Med, 2014, 3: 8-14.

1. 中华医学会风湿病分会. 系统性红斑狼疮诊断及治疗指南. 中华风湿病学杂志, 2010, 14: 342-346.
2. Dalili AR, Lotfi R, Mousavi SM. Cavitary pulmonary lesions in systemic lupus erythematosus: an unusual manifestation. Electron Physician, 2014, 6(3): 868-871.
3. Pamuk ON, Pamuk GE, Barutcu E, et al. The development of pulmonary aspergillosis and pneumothorax in a patient with neutropenic systemic lupus erythematosus and successful treatment of the first case. BMJ Case Rep, 2014. pii: bcr2013200818.
4. Tanaka N, Kusunoki Y, Kaneko K, et al. Systemic lupus erythematosus complicated by recurrent pneumothorax: Case report and literature review. Nihon Rinsho Meneki Gakkai Kaishi, 2010, 33: 162-168.
5. Maeda R, Isowa N, Miura H, et al. Systemic lupus erythematosus with multiple lung cysts. Interact Cardiovasc Thorac Surg, 2009, 8: 701-702.
6. Wilhelm M, Van Why SK. Pneumothoraces complicating systemic lupus erythematosus with nephritis. Pediatr Nephrol, 2002, 17: 261-263.
7. Yen JH, Tsai WC, Ou TT, et al. Systemic lupus erythematosus complicated by recurrent spontaneous pneumothorax--a case report. Kaohsiung J Med Sci, 2001, 17(10): 540-544.
8. 黄华瑞, 杨虎天. 系统性红斑狼疮并发自发性纵隔气肿及气胸一例. 中华内科杂志, 2000, 39: 177.
9. Nishitsuji M, Nakamura H, Saito K, et al. A case of systemic lupus erythematodes with hemosputum and pneumothorax probably resulting from pulmonary infarction and pulmonary angitis. Nihon Kokyuki Gakkai Zasshi, 1998, 36: 71-76.
10. Paira SO, Roverano S. Bilateral pneumothorax and mediastinal emphysema in systemic lupus erythematosus. Clin Rheumatol, 1992, 11: 571-573.
11. Jay MS, Jerath R, Van Derzalm T, et al. Pneumothorax in an adolescent with fulminant systemic lupus erythematosus. J Adolesc Health Care, 1984, 5: 142-144.
12. Passero FC, Myers AR. Hemopneumothorax in systemic lupus erythematosus. J Rheumatol, 1980, 7: 183-186.
13. Richards AJ, Talbot IC, Swinson DR, et al. Diffuse pulmonary fibrosis and bilateral pneumothoraces in systemic lupus erythematosus. Postgrad Med J, 1975, 51: 851-855.
14. Sawkar LA, Easom HF. Recurrent spontaneous pneumothoraces in systemic lupus erythematosus. Chest, 1971, 60: 604-605.
15. 蔡柏蔷, 李龙芸, 主编. 协和呼吸病学(第 2 版). 北京: 中国协和医科大学出版社, 2011, 1868-1873.
16. Bouros D, Pneumatikos I, Tzouvelekis A. Pleural involvement in systemic autoimmune disorders. Respiration, 2008, 75: 361-371.
17. Singh JA, Hossain A, Kotb A, et al. Risk of serious infections with immunosuppressive drugs and glucocorticoids for lupus nephritis: a systematic review and network meta-analysis. BMC Med, 2016, 14: 137.
18. Hsu CW, Sun SF. Iatrogenic pneumothorax related to mechanical ventilation. World J Crit Care Med, 2014, 3: 8-14.

Chinese Journal of Respiratory and Critical Care Medicine

Spontaneous pneumothorax secondary to acute lupus pneumonitis: one case report and literature review

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