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Acute Lupus Pneumonitis With Normal Chest Radiograph

Irawan Susanto; Jay I. Peters
Author and Funding Information

From the Department of Medicine, Division of Pulmonary Diseases/Critical Care Medicine, the University of Texas Health Science Center at San Antonio and, the South Texas Veterans Health Care System, Audie L. Murphy Memorial Veterans Hospital Division, San Antonio, Tex.


1997 by the American College of Chest Physicians


Chest. 1997;111(6):1781-1783. doi:10.1378/chest.111.6.1781
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Abstract

Patients with acute lupus pneumonitis (ALP) usually have hypoxemia, patchy infiltrates evidenced on a chest x-ray film, and an incomplete response to corticosteroids with high mortality. In contrast, lupus patients with a syndrome of acute reversible hypoxemia (SARH) have hypoxemia with normal chest x-ray films and a rapid response to corticosteroids. We present a case of biopsy-proven ALP with normal initial chest x-ray films, and a normal CT scan. We hypothesize that a continuum of vascular and parenchymal abnormalities may exist in the lungs of lupus patients. This case also illustrates the insensitivity of routine chest radiographs in demonstrating mild or early pneumonitis.


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