La Revue de médecine interne
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Pleuro-pulmonary manifestations are frequent in systemic lupus erythematosus (SLE), being found in 40 to 70% of patients with this disease. However, these manifestations can be attributed to SLE only when other pathologies, and notably infections, have been excluded. The truly SLE-related pleuro-pulmonary manifestations can be divided into five types: pleurisy, interstitial pneumonia, lupus pneumonia and two new entities: diffuse pulmonary haemorrhage and pulmonary arterial hypertension. ⋯ Pulmonary arterial hypertension is a classical, but hitherto unrecognized manifestation of SLE which benefits from new exploratory techniques, such as doppler-ultrasonography. At present, its diagnosis rests on data supplied by cardiac catheterization which is generally performed too late, making it irreversible and resistant to all treatments. Some of these pleuro-pulmonary manifestations are probably underestimated and they require new methods of investigation, such as bronchoalveolar lavage or doppler-ultrasonography, resulting in earlier diagnosis and treatment at an accessible stage.
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Hypodermoclysis consists of infusing solutions in the subcutaneous tissues. It is a convenient means of correcting a moderate dehydration, notably in elderly people, when oral feeding is impossible or insufficient. The only potential problem with this technique is the occurrence of hypovolaemia due to infusion of hypo- or hypertonic solutions in subjects with previous severe salt and water disorders. For this reason, hypodermoclysis should not be used in emergencies.