Refractory Pleural Effusion in Systemic Lupus Erythematosus Treated by Pleurectomy

Kim, Sichan; Park, Han-bit; Cho, Yun Kyung; Yi, Sangyoung; Oh, Kyunghwan; Kim, Dong Kwan; Yoo, Bin

doi:10.4078/jrd.2017.24.1.43

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…More severe manifestations and organ damage have also been reported, including an increased incidence of renal, cardiovascular and neuropsychiatric involvement. 22 The organ involvement in this patient was pleural effusion (occurs in 45–60% of the patients with SLE), 23 hepatosplenomegaly (incidence of 39% hepatomegaly and 6% splenomegaly), 24 and extrapulmonary TB (abdominal TB was diagnosed in this patient). A cohort study in 2022 by Hamijoyo et al, stated that there were 61 out of 113 SLE patients (44.2%) with extrapulmonary TB.…”

Section: Discussionmentioning

confidence: 85%

Oral Lesion Management in Juvenile SLE with Hepatosplenomegaly

Rajasa,

Hidayat

2024

IMCRJ

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Background Systemic Lupus Erythematosus (SLE) is an autoimmune disease with unknown etiology resulting in chronic multi-organ inflammation. Juvenile Systemic Lupus Erythematosus (JSLE) is a specific diagnosis of SLE in juvenile, characterized by oral ulceration. Purpose This case report attempts to provide information for oral medicine specialists in managing JSLE patients with hepatosplenomegaly. Case Presentation A 17-year-old female patient was referred from the Pediatrics Department with mouth ulcers accompanied by dry lips and a tendency to bleed. The most concerning lesion was located on the left buccal mucosa, a single ulceration measuring 5x6mm. Multiple ulcerations spread over the upper and lower labial mucosa, with haemorrhagic crusts on the lips. Painful ulceration can lead to difficulties in mouth opening and impaired function in eating and drinking. Central erythema was seen on the palate. Pseudomembranous candidiasis was also seen on the patient’s tongue. The hepatosplenomegaly was confirmed by CT scan, with enzyme values of SGPT (386 U/L) and SGOT (504 U/L). Case Management Administration of 0.9% NaCl was instructed to the patient to maintain oral hygiene and help moisturize lips in order to remove haemorrhagic crusts. Administration of 0.025% hyaluronic acid mouthwash and topical steroid ointment mixture for ulcerated and inflammatory conditions. Drug adjustments were made based on laboratory tests and the patient’s clinical condition was improving. Conclusion Managing oral symptoms helps reduce morbidity in JSLE patients. Topical corticosteroids are considered the first line in controlling oral inflammation. Dentists play a role in improving patients’ oral hygiene with the aim of reducing the risk of other opportunistic infections.

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Section: Discussionmentioning

confidence: 85%

Oral Lesion Management in Juvenile SLE with Hepatosplenomegaly

Rajasa,

Hidayat

2024

IMCRJ

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“…A pleurectomy may be needed in rare cases of patients with refractory pleural effusion who do not respond to immunosuppressive drugs [96]. Sichan et al successfully treated such patients by performing open surgical pleurectomy [96].…”

Section: Treatmentmentioning

confidence: 99%

“…The use of IVIG (alone or combined with cyclosporin) has been reported, but further studies are needed [94,95]. Pleurectomy may be needed in rare cases [96].…”

Section: Lupus Pleuritismentioning

confidence: 99%

Systemic Lupus Erythematosus and Lung Involvement: A Comprehensive Review

Smıth

Lee

Park

et al. 2022

JCM

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Systemic lupus erythematosus (SLE) is a complex autoimmune disease with multiorgan manifestations, including pleuropulmonary involvement (20–90%). The precise mechanism of pleuropulmonary involvement in SLE is not well-understood; however, systemic type 1 interferons, circulating immune complexes, and neutrophils seem to play essential roles. There are eight types of pleuropulmonary involvement: lupus pleuritis, pleural effusion, acute lupus pneumonitis, shrinking lung syndrome, interstitial lung disease, diffuse alveolar hemorrhage (DAH), pulmonary arterial hypertension, and pulmonary embolism. DAH has a high mortality rate (68–75%). The diagnostic tools for pleuropulmonary involvement in SLE include chest X-ray (CXR), computed tomography (CT), pulmonary function tests (PFT), bronchoalveolar lavage, biopsy, technetium-99m hexamethylprophylene amine oxime perfusion scan, and (18)F-fluorodeoxyglucose positron emission tomography. An approach for detecting pleuropulmonary involvement in SLE includes high-resolution CT, CXR, and PFT. Little is known about specific therapies for pleuropulmonary involvement in SLE. However, immunosuppressive therapies such as corticosteroids and cyclophosphamide are generally used. Rituximab has also been successfully used in three of the eight pleuropulmonary involvement forms: lupus pleuritis, acute lupus pneumonitis, and shrinking lung syndrome. Pleuropulmonary manifestations are part of the clinical criteria for SLE diagnosis. However, no review article has focused on the involvement of pleuropulmonary disease in SLE. Therefore, this article summarizes the literature on the epidemiology, pathogenesis, diagnosis, and management of pleuropulmonary involvement in SLE.

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Research Progress of Lung Involvement in Systemic Lupus Erythematosus

杨¹

2023

ACM

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Refractory Pleural Effusion in Systemic Lupus Erythematosus Treated by Pleurectomy

Cited by 3 publications

References 14 publications

Oral Lesion Management in Juvenile SLE with Hepatosplenomegaly

Oral Lesion Management in Juvenile SLE with Hepatosplenomegaly

Systemic Lupus Erythematosus and Lung Involvement: A Comprehensive Review

Research Progress of Lung Involvement in Systemic Lupus Erythematosus

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