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Chest Imaging

Systemic lupus erythematosus

(SLE), an autoimmune disease in which various tissues are damaged by autoantibodies and immune complexes. Systemic symptoms are common. Many organ systems are involved, including musculoskeletal (95%), blood (85%), skin (80%), cardiopulmonary (60%), nervous system (60%), kidneys (50%) and gastrointestinal tract (40%). It is commonly associated with serositis, pleural and pericardial effusions and pulmonary abnormalities. Pleuritis or pleural fibrosis is present in up to 85% of cases at autopsy, and pleural effusion is often visible on chest radiographs in patients with SLE.

More than 50% of patients with SLE have lung disease at some time, but interstitial pneumonia and fibrosis similar to that seen in other connective tissue diseases and usual interstitial pneumonia (UIP) is relatively rare in SLE, with a prevalence of only a few percent (Fig.1). More common pulmonary abnormalities include pneumonia, lupus pneumonitis and pulmonary haemorrhage. Each of these can be associated with HRCT findings of ground glass opacity. Also, see systemic lupus erythematosus.

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Fig.1

HRCT in a patient with SLE and mild subpleural pulmonary fibrosis.
Systemic lupus erythematosus, Fig.1