Diaphragmatic dysfunction

Bilateral elevated hemidiaphragms with diminished diaphragmatic function have been described. The clinical significance of this finding is unclear, although this phenomenon may be responsible for the 'unexplained dyspnea' in the absence of pulmonary parenchymal abnormalities in some patients. The term 'shrinking lung syndrome' has been used to described this complication. The mechanisms responsible for the diaphragmatic weakness are unknown, but may include recurrent episodes of diaphragmatic pleurisy, basal atelectasis, and steroid myopathy. Most patients with lung involvement from SLE will demonstrate a restrictive pattern on pulmonary function testing. Diaphragm dysfunction does not appear to respond to corticosteroid therapy.

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