Severe hypoxemia without pulmonary infiltrates in systemic lupus erythematosus

Abstract

Fifty percent of systemic lupus erythematosus (SLE) patients have pulmonary disease which can involve the lung parenchyma, the pleural space, and pulmonary vessels. The article reviews the causes of severe hypoxemia in a SLE patient who had pulmonary hypertension patent foramen ovale, a history of recreational drugs use, asthma, and possible antiphospholipid syndrome who presented with acute dyspnea and severe hypoxemia. Her chest x-ray revealed cardiomegaly, increased central pulmonary vessels, decreased lung volumes but no infiltrates or effusions. Severe hypoxemia without pulmonary infiltrates in SLE patients is an unusual presentation; possible explanations include pulmonary emboli, severe pulmonary hypertension, and shrinking lung syndrome.