🫁🩸 Framework for Pulmonary Disease in Lupus 🩸🫁
1st pass = Infection & Chest well pain
2nd pass = Acute vs. Chronic presentation of respiratory symptom(s)
1st pass = Infection & Chest well pain
2nd pass = Acute vs. Chronic presentation of respiratory symptom(s)
🦠 Infection:
- Low complements + Lymphopenia
- Immunosuppressive therapies
👇
- Pneumonia (typical bacterial + opportunistic)
Consider infection DDx based on type of immunocompromised state. Chest CT pattern may also be suggestive of infection type!
ncbi.nlm.nih.gov
- Low complements + Lymphopenia
- Immunosuppressive therapies
👇
- Pneumonia (typical bacterial + opportunistic)
Consider infection DDx based on type of immunocompromised state. Chest CT pattern may also be suggestive of infection type!
ncbi.nlm.nih.gov
🦴 Chest wall pain
- Easy to spot (reproducible pain, pain aggravated by motion/position)
- Common (costochondritis, muscular pain)
- Easy to spot (reproducible pain, pain aggravated by motion/position)
- Common (costochondritis, muscular pain)
After 1st pass, consider whether respiratory symptom(s) are acute vs. chronic.
ACUTE etiologies:
🫁 Pleuritis (+pleural effusion)
🫁 PE (antiphospholipid antibodies, nephrotic syndrome)
🫁 DAH (bland hemorrhage, capillaritis)
🫁 Acute pneumonitis (exclusionary via BAL!)
ACUTE etiologies:
🫁 Pleuritis (+pleural effusion)
🫁 PE (antiphospholipid antibodies, nephrotic syndrome)
🫁 DAH (bland hemorrhage, capillaritis)
🫁 Acute pneumonitis (exclusionary via BAL!)
CHRONIC etiologies:
🫁 Pulmonary HTN (multiple WHO etiologies)
🫁 ILD (least common rheum.-associated ILD, NSIP pattern most common)
🫁 Shrinking lung syndrome (no interstitial/pleural disease on imaging, low lung volumes & DLCO)
🫁 Pulmonary HTN (multiple WHO etiologies)
🫁 ILD (least common rheum.-associated ILD, NSIP pattern most common)
🫁 Shrinking lung syndrome (no interstitial/pleural disease on imaging, low lung volumes & DLCO)
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