© 2002 by Annals of the Rheumatic Diseases
LESSON OF THE MONTH
Shortness of breath in systemic lupus erythematosus: a diagnostic and therapeutic dilemma
Rheumatology Units of The Repatriation General Hospital, Flinders Medical Centre and Flinders University of South Australia, Adelaide, South Australia
Correspondence to:
Correspondence to:
Dr F Goldblatt, Department of Immunology, Allergy and Arthritis, Flinders Medical Centre, South Road, Bedford Park, South Australia 5042
Accepted 17 January 2002
Keywords: breathlessness; systemic lupus erythematosus
Abbreviations: HRCT, high resolution computed tomography; LV, left ventricle; SLE, systemic lupus erythematosus
| The first 150 words of the full text of this article appear below. |
A 30 year old woman with systemic lupus erythematosus (SLE) was admitted to hospital complaining of shortness of breath, orthopnoea, swelling of ankles, and increased weight over the preceding eight days. She otherwise felt well, and reported that her lupus was inactive. She denied any associated chest pain, cough, or fever. A similar presentation had occurred three months previously, when she went to another hospital with the same symptoms, associated with a raised temperature (38.4°C). Investigations performed at that time included a complete blood picture, cardiac enzymes, and the measurement of antibodies against double stranded DNA (dsDNA). Blood and urine cultures were normal and a chest x ray examination was normal. All blood tests were normal with the exception of a raised troponin-t level of 0.62 µg/l (normal <0.1 µg/l). An echocardiogram and high resolution computed tomography (HRCT) chest scan were also done. She was discharged from hospital and given
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