Results 1 to 3 of 3

Thread: waking up breathless

  1. #1
    Join Date
    Mar 2005
    Posts
    2
    Thanks
    0
    Thanked 0 Times in 0 Posts

    Default waking up breathless

    hi i was wondering if anyone gets this with lupus invovlement in my lungs over the last week ive been waking up gasping for breath it lasts a few secs with pain now to its very frightening isuffer from panic attacks but this is making it all worse :?

  2. #2
    Saysusie's Avatar
    Saysusie is offline Super Moderator Super ModeratorEmperor of the Universe
    Join Date
    Nov 2001
    Location
    Victorville, California
    Posts
    7,787
    Blog Entries
    10
    Thanks
    1,640
    Thanked 944 Times in 597 Posts

    Default

    Hi Isobel;
    There can be many reasons why you are having breathing difficulties with lupus. I've listed a number of lung involvments seen in Lupus so that you can have some information to compare with your symptoms in order for you to discuss it with your doctor.
    Individuals with lupus may experience chest pain on breathing, which may be associated with underlying lung involvement. Some people experience inflammation of the lungs, or lupus pneumonitis, which is often characterized by fever, productive cough, and painful and rapid breathing.Types of lung involvement in lupus can be divided up as shown below. A brief description of each is included in brackets. Lupus commonly affects the lungs and has been reported in half of all patients with lupus. Its seriousness varies from the very worrying to the totally and wholly asymptomatic, not requiring any treatment at all. It is, in general, picked up by symptoms of lung involvement (chest pain), shortness of breath, coughing up blood, or by evidence of lung involvement on clinical examination and sometimes by special tests. Diagnosis may be simple or difficult depending on the type of underlying lung involvement.

    1. Pleural Disease (Inflammation of the lung lining)
    This is a disorder of the lining of the lung (pleura) and is the commonest manifestation of lung involvement in lupus. Inflammation gives rise to pleurisy, a type of chest pain characterised by sharpness, which is worsened by breathing in. The pain has a knife-like quality. this sort of problem has been recorded in about half of all patients with lupus. It may also occur without giving rise to any symptoms and has been seen in many patients who do not recall having had any chest pain at all. If the pleura does become inflamed then fluid may collect. this is normally small volumes and it is unusual to get large collections around the lungs.
    The fluid that collects around the lungs in patients with lupus has certain characteristic abnormalities which may assist the doctor in diagnosing what the cause of the fluid is. In all patients other causes of fluid in the lungs needs to be excluded. the main lines of treatment are non-steroid anti-inflammatory drugs but small doses of oral steroid tablets (Prednisolone) are sometimes required to effectively relieve the pain. More aggressive treatments including surgical removing of the lining of the lung are, fortunately, rarely needed.

    2. Acute Lupus Pneumonitis (lung inflammation)
    This type of lung disease is fortunately rare and typically affects about 5% of all lupus sufferers. the patients present with shortness of breath, couch, rapid breathing and occasionally coughing up blood. What happens is that there is marked increase in the number of white cells within the lung which produces the clinical symptoms. The reason for this is unknown. Most patients who develop this complication have lupus involvement in other organ systems. An infectious cause for the symptoms must be rigorously excluded. High dose steroids are the mainstay of treatment.

    3. Pulmonary/Alveolar haemorrhage (Bleeding into the lungs)
    This is a very rare, dangerous manifestation of lupus. the presentation is similar to that of acute lupus pneumonitis but coughing up blood is a prominent symptom; this may be so bad that a patient loses so much blood that the blood pressure falls and they become shocked. in most patients this occurs in a background of pre-existing involvement of other organ systems. the blood count falls and the chest X-ray typically shows fluffy shadows. the diagnosis is made on the clinical presentation and by taking some lung to look at under the microscope. Aggressive treatment at a centre with experience is most likely to lead to a good outcome.

    4. Diffuse Interstitial Lung Disease
    This complication, which is seen commonly in rheumatoid arthritis, affects a small percentage of patients with lupus. the commonest presentation is a chronic cough, without sputum, and shortness of breath on mild exertion. the X-rays of such patients may be normal in the early stages but later show either small areas of thickened lung tissue, particularly at the bottom (bases) of the lungs. Breathing tests suggest that the lung is not as effective at exchanging gases as it ought to be. Lung scan (CT scan) gives a definitive diagnosis and will often show much of the changes are due to inflammation and how much due to the thickening and scarring. treatment is with (initially) high dose steroid and steroid sparing agents. there are also a number of experimental treatments which had not yet been validated by well designed controlled trials.

    5. Pulmonary Embolism or clots on the lungs
    This complication, whereby a clot which has formed in the calf veins, breaks off and travels through the venous system and ends up in the lungs causing death to a small a part of the lung. Although this may be seen in otherwise normal people, it is commoner in patients with lupus. It is much more common in those patients with lupus who have a circulating lupus anticoagulant or other anti-phospholipid antibodies. Treatment involves determining what the underlying cause is and thinning the blood down with initially Heparin, which is given by intravenous injection and later by Warfarin, tablet given by mouth. (See Hughes' Syndrome).

    6. Pulmonary Hypertension (High blood pressure in the lungs)
    Severe high blood pressure within the lungs is rare but mild cases are much more common. The most common complaints are shortness of breath on exertion and a chronic cough. Fatigue is another common but difficult to assess symptoms. It is thought that there is a strong genetic contribution to the development of this condition. there are a large number of treatments which can be tried, but none are terribly successful.

    7. Shrinking Lung Syndrome
    This was first described in a group of patients in 1965. The main symptom is shortness of breath with exertion but the patients are otherwise clinically well. the chest X-ray does not show any shadow, but the amount of lung available for gas exchange is markedly reduced. the diaphragm, which inflates the lung, also appears not to be working normally in such cases. This tends to be a chronic, low grade problem and treatment is with steroids but it is not always effective.

    8. Airflow Limitation (narrowing of the airways)
    This is seen in a small number of patients and is strongly associated with cigarette smoking, but it can occur in patients who have never smoked at all. It is thought that this condition is worsened by fatigue of the muscles of breathing which has been seen in 75% of lupus patients. Treatment is with sprays to open up the airways and perhaps tablets to assist this. the main symptoms are shortness of breath of exertion, sometimes accompanied by wheeziness.

    9. Infection of the lungs (bronchitis and pneumonia)
    This is commoner in patients with lupus than those without. this is partly due to the lupus itself and partly due to the use of steroid and other immunosuppressive drugs used to treat the underlying lupus. The presentation and clinical course of infection in lupus is often different to that of patients without lupus.

    Best of Luck
    Saysusie

  3. #3
    Join Date
    Apr 2013
    Posts
    8
    Thanks
    4
    Thanked 0 Times in 0 Posts

    Default Shortness of breath

    [QUOTE=Saysusie;2131]Hi Isobel;
    There can be many reasons why you are having breathing difficulties with lupus. I've listed a number of lung involvments seen in Lupus so that you can have some information to compare with your symptoms in order for you to discuss it with your doctor.
    Individuals with lupus may experience chest pain on breathing, which may be associated with underlying lung involvement. Some people experience inflammation of the lungs, or lupus pneumonitis, which is often characterized by fever, productive cough, and painful and rapid breathing.Types of lung involvement in lupus can be divided up as shown below. A brief description of each is included in brackets. Lupus commonly affects the lungs and has been reported in half of all patients with lupus. Its seriousness varies from the very worrying to the totally and wholly asymptomatic, not requiring any treatment at all. It is, in general, picked up by symptoms of lung involvement (chest pain), shortness of breath, coughing up blood, or by evidence of lung involvement on clinical examination and sometimes by special tests. Diagnosis may be simple or difficult depending on the type of underlying lung involvement.

    1. Pleural Disease (Inflammation of the lung lining)

    Hi all,

    I came to the forum looking for this topic. I got my first tentative diagnosis of Lupus in September 2011 although I'd been seriously sick since the summer of 2009. Several times I ended up in the ER with sharp pains and shortness of breath. At first they diagnosed it as stress, then bronchitis. Once even pluerisy. In the myriad of symptoms preceding the Lupus diagnosis, shortness of breath has always been there. It's an indicator that my bp is up, or my blood sugar is up, or that a flare is in the works.

    But these last few months while most other Lupus symptoms have been in pretty good control, I continue to have bouts of shortness of breath. When it's accompanied by the sharp pains, I know I need more prednisone. When I wake up in the night, it's usually a panic attack. Over the last month, I've been on Levaquin for a sinus infection and again, when I run a low grade fever at night, I have a little trouble breathing all the way in. I've found when I try to breathe deeply 2 or 3 times in a row and can't, it causes me to cough and then to feel nauseous. I'm in process of titering down my dosage of Prednisone and wonder if that can have anything to do with the come-and-go breathing issues? Or is it possible to have pleurisy without the sharp pain? It feels like I have to think to breathe, is almost always worse at night or when I'm lying down. When they check my pulse ox it's fine and there's no congestion in my chest. As seems to always be the case, my pcp and the doctors at the ER don't know anything about Lupus and I don't have insurance so I can't afford a specialist at this point. Any ideas?

    PJ

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •