Shrinking lung syndrome in systemic lupus erythematosus patients with dyspnea

Shrinking Lung Syndrome in a Systemic Lupus Erythematous Patient Improved by Rituximab: A Case Report With Literature Review

Shrinking lung syndrome (SLS) is a rare complication of autoimmune and connective tissue diseases like systemic lupus erythematosus (SLE). A 35-year-old female patient, diagnosed with SLE, came to the hospital complaining of severe dyspnea and pleuritic pain for several months that was worsening on exertion. Imaging (X-ray and CT scan) of the chest at the time of presentation showed bilateral basal atelectasis with elevated diaphragm. Pulmonary function test (PFT) showed restrictive findings including forced expiratory volume in the first second (FEV1) of 37%, total lung capacity of 40%, and vital capacity of 32% predicted with a restrictive pattern on flow volume loop confirming the diagnosis of SLS. The treatment focused on methotrexate and rituximab. Patients with a known history of SLE who start respiratory symptoms like cough and dyspnea should be ruled out of SLS at the earliest as it can be deadly in the later stages.

Shrinking Lung Syndrome: A Case Report

Shrinking Lung Syndrome (SLS) is an uncommon complication of systemic lupus erythematosus (SLE). SLS is a diagnosis of exclusion with features of dyspnea ruled out by other causes using imaging and diagnostic studies, pleuritic chest pain, and elevated diaphragm. Currently, there are many theories of the etiology; however, there is no clear pathogenesis, conclusive treatment, and preventative measures. We report a case of a 41-year-old woman with SLE admitted for pleuritic chest pain with unclear cause of shortness of breath. After CTA chest study, laboratory, chest x-ray, and pulmonary function test we were able to appropriately diagnose her with SLS and treat her with steroids as per limited current research guidelines.