Lupus Symptoms Diagnosis Serositis

Serositis is the inflammation of the serous membranes (sacs) that surround organs. Serositis is one of the symptoms of lupus listed in the criteria of the American College of Rheumatology. This symptom is known to affect up to 45 percent of people with lupus. Examples of serositis that can be affected by lupus are pleurisy and pericarditis.

Pleurisy and the Lungs

Pleurisy is an inflammation of the membrane that surrounds both lungs. This membrane is called the pleura. Pleurisy can cause sharp chest pains that worsen when taking a deep breath or coughing.

Causes of Pleurisy

Pleurisy can be a result of many different medical conditions besides lupus. A doctor cannot diagnose lupus based on the presence of pleurisy alone. Some of the conditions that can lead to pleurisy are:

  • lung infection
  • pulmonary embolism (blood clot)
  • lung cancer
  • rheumatic fever
  • connective tissue disorders
  • radiation therapy
  • pneumothorax (accumulation of gas in the pleural cavity)
  • pericarditis (inflammation of the pericardium, the sac that surrounds the heart).

Moving Towards the Lupus Diagnosis

Doctors will perform tests to determine the underlying cause of pleurisy. A chest x-ray can show conditions like pneumonia, tuberculosis, blood clots, cancer or fluid in the chest. Other tests can help determine whether pneumonia, rheumatic fever or blood clots exist. Doctors rule out all other conditions before making a diagnosis of lupus.

Pericarditis and the Heart

Another type of serositis related to lupus is pericarditis. Pericarditis is the inflammation of the sac (pericardium) that surrounds the heart. Pericarditis causes fluid to build up in the pericardium, making it more difficult for the heart to pump blood. The extra work of the heart causes chest pain. If the pericarditis is severe, the chest pain may increase with normal activity like swallowing, coughing or even breathing.

Causes of Pericarditis

Like pleurisy, pericarditis can be symptomatic of other illnesses besides lupus. Doctors must rule out other conditions before they consider pericarditis as a result of lupus. Other conditions that lead to pericarditis are:

  • viral infection
  • pus-producing infection
  • tuberculosis
  • kidney failure
  • heart attack
  • heart injury or trauma
  • rheumatoid arthritis
  • scleroderma
  • collagen vascular diseases.

Other Heart Involvement

Severe pericarditis can lead to inflammation of the heart muscle (myocarditis), although this condition is not a common symptom of lupus. Still, myocarditis can be dangerous because it can exist without the presence of symptoms. Consequently, myocarditis can be overlooked until the muscles of the heart become weak and lose effectiveness. This can lead to arrhythmias or irregular heart beats. Eventually, the heart’s inability to meet circulatory demands can cause blood to back up in the heart and lead to heart failure.

Treatment of Serositis

Treating pericarditis or pleurisy is depends on the disease that is causing the condition. Therefore, diagnosing the original condition will dictate the best method of treatment. If a lupus diagnosis has been made, the treatment of these conditions follows treatment directions for other lupus symptoms. Patients are encouraged to get plenty of rest and to take non-steroidal anti-inflammatory medications (aspirin or ibuprofen). Persistent pain and inflammation may require a course of corticosteroids such as prednisone.


Beers, M.H.