J Clin Rheumatol. 2010 Mar;16(2):68-70.

Successful treatment of shrinking lung syndrome with rituximab in a patient with systemic lupus erythematosus.

Benham H, Garske L, Vecchio P, Eckert BW.

Source

Department of Rheumatology, Princess Alexandra Hospital, Queensland, Australia. helenh@gmp.usyd.edu.au

Abstract

Shrinking lung syndrome (SLS) is a rare manifestation of systemic lupus erythematosus (SLE). We report the case of a 27-year-old woman with SLE presenting with a 2-year history of chest pain and progressive dyspnea. Respiratory function tests demonstrated severe restrictive ventilatory impairment. Chest x-ray demonstrated elevated hemi diaphragms and chest computed tomography showed no evidence of interstitial fibrosis, significant pleural disease or pulmonary emboli. Based on a diagnosis of SLS the patient received 4 months of high dose corticosteroids, mycophenolate and pain management with opiates. Her condition deteriorated and she was given a trial of rituximab. This resulted in marked improvement of the clinical condition and respiratory function tests that was maintained for 18 months. Subsequently, the patient represented with a similar clinical picture and another course of rituximab again produced remission. This is the first case report of reproducible remission of SLS in SLE treated with rituximab.

PMID:: 20216126; [PubMed - indexed for MEDLINE]

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