Lupus and Pneumonitis

[Dbilbao]

In the last two years after having caught a "cold" I have been left with a long lasting severe cough (to the point of needing to throw up) that has absolutely no evidence of any infection at all.  I also experience chest tightness and trouble breathing.  My GP x-rayed for pneumonia, no sign.  she put me on antibiotics with no help at all, and like I said, there is no sign at all of infection.  Albuterol did improve my peak flow, but I am beginning to think that it is more related to my lupus and may be more of an inflamation (inflammation) thing.  I have SLE/RA and am on about a bzillion medications including arava, prednisone, imuran, plaquenil.  Is it possible that I have Pneumonitis?

[National Jewish]

Pneumonitis is another term for pneumonia.  If you had pneumonitis, it would have been seen on your chest x-ray.

Viral infections like a cold can cause inflammation of the airways of the lungs.  This inflammation can cause coughing and chest tightness.  After the cold is gone, it is possible for the inflammation to linger.  This inflammation can last for several weeks.  Sometimes this inflammation may linger for 3 to 6 months.  Eventually the inflammation will go away, and then the coughing and chest tightness will stop.  This is called reactive airways disease (RAD).  When this inflammation is treated with an inhaled steroid, which is used to treat asthma, it often clears more quickly.

When this continues, it is generally considered to be asthma.  To know for sure if your symptoms are due to asthma or RAD testing will need to be done.  Generally testing starts with a simple breathing test called spirometry.  This test provides detailed information about how your lungs are working.  It will show if there is obstruction in your airways.  To really test for asthma it is best to repeat this test after using a rescue inhaler, like the albuterol.  This measures how much the bronchodilator helps your lungs by reversing the problem.  When there is a 20% increase, the test is positive for asthma.

[Trista]

Hi. I have SLE too and have been short of breath for a few years, and had what seemed like tight lungs. My doc gave me a pulmonary function test and I discovered that I lost a lot of my lung capacity.  The diagnosis was probably interstitial lung disease secondary to the SLE (you can also get it from RA).  I'm following up with a pulmonologist for treatment. I'm going to have a high resolution CT Scan to check for permanent scarring cause by the inflammation in my lungs. (My regular chest x-ray was normal and gave no hint as to my condition.)

Of course, I have no idea if what you have is interstitial lung disease, but I would have a pulmonary function test anyway which can tell you a lot about your lungs. Please follow up with a pulmonologist, at any rate. I hope you feel better.

[Dbilbao]

Thanks Trista.  Since I posted, the bad girl that I am, I adjusted my prenisone level up just to see and yup, I'll be damned if the coughing has abated some.  I am pretty sure that I have non-infectous pneumonitis.  But I will consult my Rheumie next time I see him.  I hope that you feel better too.  Happy Thanksgiving.

Dana