Upper airway disease in systemic lupus erythematosus: a report of 4 cases and a review of the literature.

We report the occurrence of life threatening upper airway complications in 4 of 158 patients with systemic lupus erythematosus (SLE) admitted to our hospital over a 6-year period and review published reports on this complication. The patients included in our study were identified through a computer search of our hospital medical records. Patients' charts were reviewed and the diagnosis confirmed by currently accepted criteria. The clinical features of SLE in all the published cases were assessed and compared to those found in our patients. We found that although upper airway involvement is uncommon in SLE, occurring with a relative frequency of 4/158 patient admissions, endotracheal intubation in patients with active SLE may result in the development of life threatening upper airway complications. We suggest that patients with active SLE who require intubation should be observed for the development of upper airway symptoms.