Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with pleuritic chest pain, sharp and localized, exacerbated by deep inspiration and coughing. Associated with dyspnea, non-productive cough, and systemic symptoms of SLE flare (fatigue, arthralgia, fever). Denies hemoptysis or orthopnea. Symptoms consistent with serositis secondary to systemic lupus erythematosus.
Clinical Examination Findings
Respiratory exam reveals decreased chest wall excursion on the affected side, dullness to percussion at the lung base, and diminished breath sounds. A pleural friction rub is audible on auscultation. No signs of tension pneumothorax or severe respiratory distress. Cardiovascular exam: S1/S2 normal, no signs of pericardial effusion or tamponade.
Treatment Protocol
Initiate NSAIDs for symptomatic relief of pleuritic pain. Consider short-course systemic corticosteroids (e.g., Prednisone) for moderate-to-severe serositis. Optimize baseline SLE therapy (Hydroxychloroquine, immunosuppressants). Monitor for pleural effusion; perform thoracentesis if clinically indicated for diagnostic or therapeutic purposes.