In lupus, the immune system can mistakenly attack various body parts, including the pleura, of the membrane encasing your lungs.

Lupus, or systemic lupus erythematosus (SLE), is an autoimmune disease that can cause inflammation in different body parts, including your pleura, which lines your chest cavity and surrounds your lungs.

Pleural inflammation is also known as pleurisy.

This inflammation can cause sharp chest pain when breathing, as the normally smooth pleural layers become rough and may rub against each other when you breathe in and out.

Pleurisy, which is inflammation around your lungs, isn’t technically a symptom of lupus, but it is a common complication. It affects about 43% of people with the condition. Autopsy studies have shown that different forms of lung lining disease, including pleurisy, can be present in as many as 93% of people with lupus.

Inflammation of your pleura can cause chest pain, particularly when taking deep breaths or coughing, and may also lead to difficulty breathing. It’s one of the many ways in which lupus can affect various organs and tissues in your body.

Symptoms of pleurisy in lupus

In lupus, pleurisy can present with various symptoms, which may include:

  • Chest pain: Pleuritic chest pain is a hallmark symptom of pleurisy. It’s often described as sharp, stabbing, or aching pain and tends to worsen with deep breathing, coughing, or sneezing.
  • Dyspnea (shortness of breath): Individuals with lupus-related pleurisy may experience difficulty breathing, especially when taking deep breaths.
  • Cough: Some individuals may develop a dry or productive cough.
  • Chest tenderness: Your chest wall may become tender to the touch.
  • Fever: Fever can be associated with pleurisy, particularly if there’s an underlying infection.

Pleurisy in lupus is diagnosed through a combination of clinical evaluation, medical history, imaging tests, and analyzing fluid around your lungs. Doctors or healthcare professionals will assess your symptoms, conduct imaging studies like chest X-rays, MRI, or ultrasound, and may perform tests on the pleural fluid obtained through a procedure called thoracentesis.

This fluid can provide important clues. For example, in SLE-related pleuritis, the fluid might show signs like elevated levels of certain proteins, low glucose levels, and high levels of lactate dehydrogenase.

Positive antinuclear antibodies (ANAs) in the fluid may also suggest an autoimmune origin. But it’s important to note that a positive ANA result should be interpreted cautiously, as it can also occur in other conditions, including some cancers.

Learn more about lupus diagnosis

A diagnosis of lupus often relies on a combination of blood tests, imaging tests, a urinalysis, and a clinical evaluation. Reach out to a healthcare professional for a proper diagnosis and treatment plan if lupus is suspected.

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Pleurisy in lupus is typically treated by addressing the underlying autoimmune condition (lupus) and managing the associated inflammation and pain.

Treatment may involve the following approaches:

  • Immunosuppressive medications: Lupus is an autoimmune disease, and medications that suppress the immune system are often prescribed to control the overactive immune response. Common immunosuppressive drugs include corticosteroids (e.g., prednisone) and disease-modifying antirheumatic drugs (DMARDs) like hydroxychloroquine, azathioprine, or mycophenolate mofetil.
    • In some situations, other medications like rituximab or belimumab, which modulate your immune system, may be considered for lupus treatment.
  • Pain management: Pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pleuritic chest pain. Over-the-counter options include ibuprofen or aspirin, but prescription-strength NSAIDs may be necessary for severe pain.
  • Lifestyle changes: Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking, can help manage lupus symptoms and improve your overall health.
  • Biologic medications: Biologics are a newer form of medication that may be effective for lupus treatment. Rituximab or belimumab are commonly recommended.

The duration of pleurisy in lupus can vary widely from person to person. It may be an acute, short-term episode or a chronic, recurring symptom of lupus. In some cases, pleurisy may last for a few days or weeks and resolve with treatment, while in others, it may persist or recur over an extended period.

Lupus is a chronic autoimmune disease characterized by periods of flares (when symptoms worsen) and remissions (when symptoms improve). Pleurisy often occurs during lupus flares when inflammation in the pleura is more active.

Learn more about lupus flares here.

Pleurisy is a medical condition characterized by inflammation of the pleura, which is the double-layered membrane surrounding your lungs and lining your chest cavity.

Pleurisy can be caused by various underlying conditions, including infections, respiratory disorders, or autoimmune diseases, such as lupus.

If you have lupus and experience chest pain or breathing difficulties, it’s important to get a medical evaluation to rule out other potential causes and manage your condition effectively. Early detection and treatment are key to managing lupus-related pleurisy and preventing complications.