Inflammation, lupus and the lungs

lungsheartdiaphragmLupus affects the lungs in numerous ways and I’ll only detail a few. However, before going into any detail, it is worth mentioning that the lungs and the heart are a pretty intricate duo. They march to the ‘beat’ of the heart, but the lungs have a lot to ‘say’ about how our body functions. Remember the old ditty, “You can’t have one without the other…” The very simple image to the left adds on one more body part, often forgotten, to make a trio out of this important duo, the diaphragm. However, suffice it to say, that whenever there is lupus involvement in respiration, THINK INFLAMMATION.

The image shows the red heart tucked in between the pink left and right lobes of the lung; the brown/tan organ on which the lungs appear to rest is the diaphragm. I won’t address the diaphragm much except to say that the it acts much like a set of bellows: the muscle that powers the lungs to expand and contract so that ‘in goes the good air and out goes the bad.’

The inflammation caused by lupus can affect the lungs in numerous ways; but mainly by:

  • causing inflammation of the lining of the lung
  • causing inflammation of the lung itself
  • causing inflammation of the blood vessels within the lungs
  • it can affect the diaphragm.

INFLAMMATION OF THE LINING OF THE LUNG:

  • Inflammation of the lining of the lung (pleura) usually called pleuritis (‘itis’-inflammation) which results in pain called pleuritic chest pain or pleurisy. A hallmark of pleurisy is pain when you breathe in (inhalation).

INFLAMMATION OF THE LUNG ITSELF:

  • Inflammation of the lung tissue itself is often called interstitial lung disease (ILD). Examples of ILD include pulmonary fibrosis, interstitial pneumonitis, and sarcoidosis and their symptoms often include shortness of breath.
  • Inflammation of the soft tissue (cartilage) between the ribs often results. When the ribs expand during inhalation, pain is the result. This is called costochondritis and is often a recurring ailment in lupus patients. Again this is a cause of pain in the chest; ANY chest pain should be evaluated by a health care professional. This pain can also mimic that of a heart attack or pleurisy so your doctor must conduct a thorough physical exam.

Those are two examples of conditions resulting from inflammation of structures in the lung.

If vasculitis is of a small blood vessel, it can break and blue dots can be seen on the skin from the breakage. If vasculitis effects a larger blood vessel, it may be noticed as a larger node near the surface of the skinIf the inside of a blood vessel becomes inflamed, there can be a decrease in blood flow that results in less oxygen getting through.

INFLAMMATION OF THE DIAPHRAGM: Lupus can affect diaphragm because of repeated inflammation the diaphragm can lose it’s ability to generate the pressures needed to expand and contract. On rare occasion this results in “Shrinking Lung Syndrome” (SLS). On x-ray or a high-resolution CT scan, the lungs look clear. This condition is rare, but can be serious because the lungs themselves are not muscular and are only powered by the diaphragm. No diaphragm, no air exchange.

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