Title:Cardiovascular and Pulmonary Manifestations of Systemic Lupus Erythematosus
Volume: 13
Issue: 3
Author(s): Konstantinos Tselios and Murray B. Urowitz*
Affiliation:
- Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Lupus Clinic, University Health Network, Toronto, Ontario,Canada
Keywords:
Systemic lupus erythematosus, cardiovascular, pulmonary manifestations, viral, tuberculosis, uremic.
Abstract: Background: Systemic lupus erythematosus (SLE) is characterized by various clinical manifestations
and immunologic abnormalities. Cardiovascular and respiratory system involvement are increasingly
recognized as critical for patients’ prognosis. In this review, current knowledge concerning diagnosis, pathogenesis
and treatment of the cardiac and pulmonary lupus manifestations are discussed.
Method: Review of the literature.
Results: Although pericarditis is the most frequent heart manifestation in the context of lupus, valvular disease
and less often myocarditis may be detected. In the latter, treatment should be prompt and aggressive to
prevent chronic sequelae like congestive heart failure. Later on disease course, accelerated atherosclerosis is
considered as one of the most important co-morbidities of SLE with cardiovascular events being one of the
leading causes of death at relatively young ages. Stratification of the patients at risk and stringent management
of the traditional risk factors are warranted.
Respiratory system involvement affects all anatomic structures of the lungs, pleura and pulmonary vasculature
while its severity ranges from asymptomatic pleural disease to acute respiratory failure. The most common
features include pleuritis, interstitial lung disease and pulmonary embolism on the background of antiphospholipid
syndrome. Less usual complications include lupus pneumonitis, diffuse alveolar hemorrhage,
shrinking lung syndrome and pulmonary arterial hypertension.
Conclusion: There are no specific guidelines for the management of these manifestations and therapeutic
approach remains empiric.
