Occasionally, people with lupus develop pulmonary hypertension or high blood pressure in the blood vessels within the lung. If severe, this can be life-threatening, and there tends to be little chance for improvement.
Treating pulmonary hypertension
There is no uniformly successful medical treatment for pulmonary hypertension. Heart-lung transplants may be an option for some people with pulmonary hypertension caused by SLE.
Pulmonary emboli are blood clots that block the pulmonary arteries.
Symptoms of pulmonary emboli
- At first, the clots cause pleuritic (lung) pain and shortness of breath.
- These clots can lead to abnormal oxygen exchange in the lung and even death.
Diagnosing pulmonary emboli
- ventilation-perfusion (breathing and blood flow) scans of the lung
- angiography (dye injected into an artery)
- an evaluation for thrombophlebitis (inflammation of a vein due to a blood clot)
Risk factors in lupus for pulmonary emboli
- antiphospholipid antibodies
- decreased blood levels of protein S
- possible vascular damage
- prolonged bed rest.
Pulmonary hemorrhage, or bleeding into the lung, is a rare but potentially fatal complication of SLE.
Symptoms of pulmonary hemorrhage
- shortness of breath
- a cough
- blood-tinged sputum.
Diagnosing pulmonary hemorrhage
These symptoms are usually seen in the setting of multi-organ system involvement from SLE and a rapidly falling red blood count.
Treating pulmonary hemorrhage
Treatment usually includes high-dose corticosteroids with immunosuppressive agents. Aggressive supportive care is also crucial to maximize chance for recovery.
The broad array of cardiopulmonary problems associated with SLE requires a close working relationship between patient and physician. Preventive measures to reduce the number of flares and rapid evaluation of new or changing symptoms is crucial to minimize long-term problems. Treatment is always individualized to the type of heart and/or lung involvement. Ongoing medical supervision is essential to optimize therapy and prevent long-term side effects.
To learn more about:
Bronchoscopy with alveolar lavage (BAL)
Gastroesophageal Reflux Disease (GERD)
Lung gallium (Ga.) scan
Pulmonary ventilation/perfusion scan
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