About 50% of lupus patients will experience some form of lung involvement.

Pleurisy

The most common condition that patients may experience is pleurisy, where the membrane of the lungs and chest become inflamed. The pleural cavity, the area between the lungs and inner chest wall sits between two lubricated surfaces, called pleura. 

The most common symptom is a sharp chest pain which gets worse when breathing in deeply, sneezing or coughing. Other symptoms include a dry cough, shortness of breathe/rapid shallow breathing, fevers and chills. Sometimes the symptoms are so mild that the patient doesn't realise they have pleurisy and it resolves on its own.

Pleurisy is not contagious. However, sometimes it's infections such as influenza (flu), pneumonia and tuberculosis which may cause pleurisy, are all contagious conditions. 

Pneumonitis

A rare condition (1-10% of patients) is Acute lupus pneumonitis  which usually comes on quickly, caused by inflamation of the actual lung. This is a potentially serious condition with similar symptoms to pleurisy: chest pain, shortness of breathe and a dry cough which may bring up blood. It's important that this condition is treated immediately so if you experience unfamiliar lung pains or any of these symptoms you should consult your doctor straight away.

A related condition is chronic lupus pneumonitis, which builds up over a period of time, indeed some patients may not realise they have it. 

Pulmonary Hypertension

The term pulmonary hypertension describes a condition where the pressurein the arteries from the heart to the lungs are high. This is a rare complcation of lupus and the main symptom is breathlessness. If it is not recognised and treated it can lead to heart failure. Raised pressures in the pulmonary arteries can be caused by blood clots in the lungs (pulmonary emboli), lung scarring or inflammation or from inflammation of the lung arteries themselves. Diagnosis can be difficult, especially in the early stages and specialist help from a cardiologist and chest physician may be needed. Treatment involves specialised drugs to reduce pulmonary artery pressures.

Shrinking Lung Syndrome

This is a rare complication of SLE, where the lungs seem to be disappearing on x-ray. The symptoms are similar to other conditions above including shortness of breathe and chest pain whilst breathing in. The diagnosis is established by comparing chest x-rays and breathing tests over time. 

The treatment of lung involvement in lupus will often involve steroid treatment to quickly reduce inflammation. In people with recurrent episodes, immune suppressing drugs may be necessary.

In summary if you have chest pain/the need to breath rapidly, shortness of breath/dry cough or cough that brings up blood/pain in your lungs you should immediately consult your doctor, especially if you have difficulty breathing or if any of the pains are intense.

If you smoke you should make every effort to stop. Smoking is a health hazard for everyone but particularly for lupus patients. Your GP will be able to advise you on how to get help to stop smoking.