Shrinking Lung Syndrome in Systemic Lupus Erythematosus. Case Report

Abstract

Introduction: The shrinking lung syndrome (SLS) is a rare pulmonary affectation of systemic lupus erythematosus (SLE).
Case presentation: A 20-year-old male patient diagnosed with SLE presented for dyspnea and chest pain. Imaging studies are not conclusive, and spirometry shows a severe restrictive pattern. SLS is diagnosed, and a course of immunosuppression and analgesia is started with partial improvement of the symptoms.
Discussion: SLS is an uncommon complication of SLE that presents with dyspnea on exertion, with or without pleuritic chest pain. It affects approximately 1% of SLE patients and can occur at any time during the disease. It should be suspected in patients with radiographic evidence of elevated hemidiaphragm and restrictive physiology in pulmonary function tests in the absence of another cause. Initial treatment is usually with corticosteroids. Most patients improve with treatment.
Conclusion: SLS is a rare pulmonary complication of an autoimmune disease such as SLE. Clinical suspicion, as well as knowledge of its presentation characteristics, can lead and guide to a rapid diagnosis and prevent worsening of the lung disease.