PLEURITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS: ITS IMPORTANCE AS AN EARLY MANIFESTATION IN DIAGNOSIS

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Abstract
Among 77 consecutive proven cases of systemic lupus, pleuritis occurred in at least 51. Of the 57 whose X-rays were available to the authors, pleuritis was an isolated first sign in 3, and in 16 more it was a notably early sign. Of the signs which preceded pleuritis, arthritis was the most frequent; of those which coincided with pleuritis, pneumonitis and pericarditis were the only ones of note. There was a marked tendency of the pleuritis to clear, with or without therapy of 39 cases with adequate follow-up 14 cleared one or more episodes wholly, and 8 more cleared leaving minimal residua. Survival after the first episode averaged 39.9 months, with 23 of 42 patients still alive. Criteria for diagnosis of systemic lupus erythematosus (SLE) in life are listed. Data are also presented to substantiate the conclusion that the overwhelming majority of the pleuritic episodes were due to the underlying lupus. In view of encouraging results of therapy in SLE, the prompt study of cases with unexplained pleuritis is urged, for SLE as well as for tuberculosis or neoplasm.