Abstract
Systemic lupus erythematosus (SLE) can involve the respiratory system through various manifestations, including the rare pulmonary complication known as shrinking lung syndrome (SLS). SLS is characterised by progressive dyspnoea, pleuritic chest pain, diaphragmatic elevation, reduced lung volumes, a restrictive pattern on pulmonary function tests, and decreased diffusing capacity for carbon monoxide. Diagnosing SLS is challenging, as it requires ruling out interstitial lung disease and significant pleural pathology. While the onset of SLS varies, it typically occurs around 4 years after SLE diagnosis. Here, we report the case of a 33-year-old woman with SLE who developed SLS as an unusual early manifestation of the disease. SLS should be considered in the differential diagnosis of respiratory symptoms in patients with suspected or confirmed SLE, even in its early stages. Early recognition and appropriate management are essential for optimising outcomes.