J Rheum Dis.  2017 Feb;24(1):43-47. 10.4078/jrd.2017.24.1.43.

Refractory Pleural Effusion in Systemic Lupus Erythematosus Treated by Pleurectomy

• Kim S
• Park HB
• Cho YK
• Yi S
• Oh K
• Kim DK
• Yoo B

• KMID: 2371677
• DOI: http://doi.org/10.4078/jrd.2017.24.1.43

Abstract

Pleural effusion is a common pulmonary manifestation of systemic lupus erythematosus (SLE) and often occurs as bilateral exudative pleural effusion. The condition usually responds quickly to corticosteroid therapy. However, massive pleural effusion refractory to immunosuppressive drugs has rarely been reported; thus, the proper therapeutic modality is largely decided on a case-by-case basis. In this case, we describe successful treatment with surgical pleurectomy for massive refractory pleural effusion in a patient with SLE.

Keyword

Systemic lupus erythematosus; Pleural effusion; Fibrothorax; Pleurectomy

MeSH Terms

Humans
Lupus Erythematosus, Systemic*
Pleural Effusion*

Figure

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  Figure 1. Chest X-ray showing bilateral pleural effusion.

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  Figure 2. Chest X-ray showing persistent bilateral pleural effusion after pleurodesis of right pleura and rituximab administration.

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  Figure 3. Chest computed tomography showing bilateral pleural effusion with multilo-culated effusion in both hemi-thoraces.

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  Figure 4. Chest X-ray showing remaining bilateral cardio-phrenic angle blunting but a decreased amount of both pleural effusions after pleurectomy.

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  Figure 5. Drug history and systemic lupus erythematosus (SLE) disease activity index-2K score. HCQ: hydroxychloroquine, MMF: mycophenolate mofetil, SLEDAI-2K: SLE disease activity index-2K.

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