Pulmonary manifestations in lupus, spontaneous pneumothorax, a case report

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by an immune-mediated inflammatory process that affects multiple organs, with renal involvement in approximately 40% of cases and pulmonary involvement in a range of 20% to 90%. We present the case of a 33-year-old female patient diagnosed with SLE nine years ago, with adequate medical follow-up and no toxicological history. She consulted for respiratory symptoms of two months of evolution, treated twice as pneumonia, which worsened ten days prior to her admission. Symptoms included dry cough, dyspnea on moderate exertion and pleuritic pain in the right hemithorax. Physical examination showed decreased breath sounds and tympanism on percussion in the right hemithorax. The diagnosis of spontaneous hydropneumothorax was established, with the identification of subpleural cysts in both lung fields. Infectious etiology was ruled out and the condition was attributed to lupus reactivity, requiring treatment with corticosteroid pulses and closed thoracostomy. SLE can generate pulmonary manifestations throughout its evolution, so it is essential to consider this possibility and to perform an exhaustive evaluation in patients with persistent respiratory symptoms.