胸腔病例（三四三）全身性紅斑性狼瘡併肋膜炎

10.6666/ClinMed.2017.80.6.135

沈佳儀；張書綸；彭殿王

狼瘡性肋膜炎(Lupus pleuritis) ； 全身性紅斑性狼瘡(Systemic lupus erythematosus) ； 肋膜積液(Pleural effusion)

臨床醫學月刊

80卷6期（2017 / 12 / 29）

746 - 750

繁體中文

全身性紅斑性狼瘡(Systemic lupus erythematosus)為系統性疾病，會侵犯全身器官，超過50%狼瘡病患會有肺部疾病，包含狼瘡性肋膜炎(Lupus pleuritis)、間質性肺病、肺泡出血、肺高壓、以及肺衰塞等。其中以狼瘡性肋膜炎最為常見。在臨床上，診斷狼瘡性肋膜炎需要與感染、結核性肋膜炎、以及狼瘡本身引起的腎病或心臟問題作區分。狼瘡性肋膜炎患者可能會有雙側肋膜積液，抽取化驗對於診斷有一定幫助。使用非類固醇消炎藥及類固醇的治療成效頗佳，多數患者會在三到四週內得到緩解。

1. Choi, BY,Yoon, MJ,Shin, K(2015).Characteristics of pleural effusions in systemic lupus erythematosus: differential diagnosis of lupus pleuritis.Lupus,24,321-326.
2. Good, JT, Jr,King, TE,Antony, VB(1983).Lupus pleuritis. Clinical features and pleural fluid characteristics with special reference to pleural fluid antinuclear antibodies.Chest,84,714-718.
3. Hargraves MM, Richmond H, Morton R. Presentation of two bone marrow elements; the ｀tart´ cell and ｀LE´ cell. Proc Staff Meet Mayo Clin 1948;23:25-8.
4. Hepburn, AL(2001).The LE cell.Rheumatology,40,826-827.
5. Im, CH,Park, JA,Kim, JY(2014).CXCR3 polymorphism is associated with male gender and pleuritis in patients with systemic lupus erythematosus.Hum Immunol,75,466-469.
6. Man, BL,Mok, CC(2005).Serositis related to systemic lupus erythematosus: prevalence and outcome.Lupus,14,822-826.
7. Mittoo, S,Fell, CD(2014).Pulmonary manifestations of systemic lupus erythematosus.Semin Respir Crit Care Med,35,249-254.
8. Mittoo, S,Gelber, AC,Hitchon, CA(2010).Clinical and serologic factors associated with lupus pleuritis.J Rheumatol,37,747-753.
9. Ocampo, V,Haaland, D,Legault, K(2016).Successful treatment of recurrent pleural and pericardial effusions with tocilizumab in a patient with systemic lupus erythematosus.BMJ Case Rep,2016,pii:bcr2016215423.
10. Palavutitotai, N,Buppajarntham, T,Katchamart, W(2014).Etiologies and outcomes of pleural effusions in patients with systemiclupus erythematosus.J Clin Rheumatol,20,418-421.
11. Pasoto, SG,Borba, EF,Bonfa, E(2010).Lupus pleuritis: a relevant risk factor for pulmonary tuberculosis.Lupus,19,1585-1590.
12. Pego-Reigosa, JM,Medeiros, DA,Isenberg, DA(2009).Respiratory manifestations of systemic lupus erythematosus: old and new concepts.Best Pract Res Clin Rheumatol,23,469-480.
13. Porcel, JM,Ordi-Ros, J,Esquerda, A(2007).Antinuclear antibody testing in pleural fluid for the diagnosis of lupus pleuritis.Lupus,16,25-27.
14. Rojas-Serrano, J,Pedroza, J,Regalado, J(2008).High prevalence of infections in patients with systemic lupus erythematosus and pulmonary haemorrhage.Lupus,17,295-299.
15. Smith, PR,Nacht, RI(1992).Drug-induced lupus pleuritis mimicking pleural space infection.Chest,101,268-269.
16. Teikkurt, C(2016).Drug-induced lupus syndrome.J Vasc,2,115.
17. Toworakul, C,Kasitanon, N,Sukitawut, W(2011).Usefulness of pleural effusion antinuclear antibodies in the diagnosis of lupus pleuritis.Lupus,20,1042-1046.
18. Zhao, J,Bai, W,Zhu, P(2016).Chinese SLE Treatment and Research group (CSTAR) registry VII: prevalence and clinical significance of serositis in Chinese patients with systemic lupus erythematosus.Lupus,25,652-657.