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Severe airflow limitation in two patients with systemic lupus erythematosus: effect of inhalation of anticholinergics

  • Case Report
  • Published:
Modern Rheumatology

Abstract

Airway involvement clinically presenting as dyspnea and an obstructive ventilatory defect is a rare but clinically important complication in systemic lupus erythematosus (SLE), since the airway manifestation is often progressive and resistant to systemic immunosuppressive therapy. Here we report two SLE patients with slowly progressive airflow limitation, which was clinically thought to be bronchiolitis obliterans. Both patients showed obvious improvement after inhalation of anticholinergics was started. Because anticholinergics are highly safe and never immunosuppressive, inhalation of these drugs might be useful in the therapeutic strategies for airflow limitation accompanying SLE or other collagen diseases.

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References

  1. Orens JB, Martinez FJ, Lynch JP 3rd. Pleuropulmonary manifestations of systemic lupus erythematosus. Rheum Dis Clin North Am. 1994;20:159–93.

    PubMed  CAS  Google Scholar 

  2. D’Cruz, D, Khamashta MA, Hughes G. Pulmonary manifestations of systemic lupus erythematosus. In: Wallace DJ, Hahn BH, editors. Duboi’s lupus erythematosus. 7th ed. Lippincott Williams & Wilkins; 2007. p. 678–99.

  3. Costello RW, Fryer AD. Cholinergic mechanisms in asthma. In: Barnes PJ, Grunstein MM, Leff AR, Woolcock AJ, editors. Asthma. Lippincott-Raven Publishers; 1997. pp. 965–84.

  4. Kinney WW, Angelillo VA. Bronchiolitis in systemic lupus erythematosus. Chest. 1982;82:646–9.

    Article  PubMed  CAS  Google Scholar 

  5. Katzenstein AL, Myers JL, Prophet WD, Corley LS 3rd, Shin MS. Bronchiolitis obliterans and usual interstitial pneumonia. A comparative clinicopathologic study. Am J Surg Pathol. 1986;10:373–81.

    Article  PubMed  CAS  Google Scholar 

  6. Godeau B, Cormier C, Menkes CJ. Bronchiolitis obliterans in systemic lupus erythematosus: beneficial effect of intravenous cyclophosphamide. Ann Rheum Dis. 1991;50:956–8.

    Article  PubMed  CAS  Google Scholar 

  7. Boehler A, Estenne M. Post-transplant bronchiolitis obliterans. Eur Respir J. 2003;22:1007–18.

    PubMed  CAS  Google Scholar 

  8. Estenne M, Hertz MI. Bronchiolitis obliterans after human lung transplantation. Am J Respir Crit Care Med. 2002;166:440–4.

    Article  PubMed  Google Scholar 

  9. Sharples LD, McNeil K, Stewart S, Wallwork J. Risk factors for bronchiolitis obliterans: a systematic review of recent publications. J Heart Lung Transplant. 2002;21:271–81.

    Article  PubMed  Google Scholar 

  10. Weber F, Prior C, Kowald E, Schmuth M, Sepp N. Cyclophosphamide therapy is effective for bronchiolitis obliterans occurring as a late manifestation of lupus erythematosus. Br J Dermatol. 2000;143:453–5.

    Article  PubMed  CAS  Google Scholar 

  11. Reilly JJ Jr. Chronic lung transplant rejection: bronchiolitis obliterans. UpToDate 2006.

  12. Matsuyama W, Yamamoto M, Machida K, Oonakahara K, Watanabe M, Higashimoto I, Osame M, Arimura K. A case of bronchiolitis obliterans syndrome successfully treated by Tiotropium bromide (in Japanese). Nihon Kokyuki Gakkai Zasshi. 2006;44:404–9.

    PubMed  Google Scholar 

  13. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Pharmacological treatment: bronchodilators. 2003, NIH pp. 67–71.

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Acknowledgment

The authors thank Dr. Hirokazu Yamada for discussion on this manuscript.

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Correspondence to Kimito Kawahata.

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Kawahata, K., Yamaguchi, M., Kanda, H. et al. Severe airflow limitation in two patients with systemic lupus erythematosus: effect of inhalation of anticholinergics. Mod Rheumatol 18, 52–56 (2008). https://doi.org/10.1007/s10165-007-0002-3

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  • DOI: https://doi.org/10.1007/s10165-007-0002-3

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