Pulmonary hemorrhage as a manifestation of systemic lupus erythematosus

Abstract

The authors report a case of a 19-year-old woman admitted for the investigation of fever and hemolytic anemia for the previous 2 months. As an inpatient, she had convulsions and sudden loss of consciousness, developing hemoptysis, hypoxia, and respiratory insufficiency. Examination showed pericardial effusions on the echocardiogram and bilateral alveolar condensations on the thoracic radiograph. A hypothetical diagnosis of systemic lupus erythematosus was made, and measurement of the antinuclear factor was requested along with daily pulse therapy methylprednisolone, in spite of which the outcome was fatal. Afterwards, the result of the antinuclear factor test was positive, with a titer of 1:5120, showing a fine punctiform pattern, fulfilling the criteria for systemic lupus erythematosus according to the American College of Rheumatology. Secondary pulmonary hemorrhage in this connective tissue disease is an uncommon but serious complication that involves a high level of mortality in spite of intensive treatment, as is also reported in the literature.

Mesenchymal stem cell transplantation for diffuse alveolar hemorrhage in SLE

“…the therapeutic protocol for sle-associated DaH is not well defined. early treatment with high-dose intravenous corticosteroids is the mainstay of therapy, but this is not effective for every patient, 9 including the patient described in this report. when the patient was referred for uC-msCt, her condition was so critical that treatment with cyclophosphamide, which often exerts a slow and moderate level of immunosuppression, was inade quate.…”

Bleeding events in pulmonary arterial hypertension

“… First, patients with connective tissue diseases, such as systemic sclerosis [5–12] or lupus erythematosus [13–17], in whom the risk of gastrointestinal bleeding or pulmonary bleeding may be higher compared with IPAH patients [2]. Second, patients with PAH related to congenital heart disease (CHD) may be at some increased risk of haemoptysis [18,19].…”

“…• First, patients with connective tissue diseases, such as systemic sclerosis [5][6][7][8][9][10][11][12] or lupus erythematosus [13][14][15][16][17], in whom the risk of gastrointestinal bleeding or pulmonary bleeding may be higher compared with IPAH patients [2].…”

Diffuse alveolar haemorrhage secondary to warfarin therapy for atrial fibrillation: a case report and literature review

“…Depending on the aetiology of the haemorrhage, there may be associated pulmonary capillaritis, neutrophil infiltration, interalveolar septal capillary thrombi, and even capillary wall necrosis 1. Some of the disorders that can cause this condition include Churg-Strauss syndrome,2 Wegener’s granulomatosis,3 systemic lupus erythematosus,4 Goodpasture’s syndrome,5 acute post-streptococcal glomerulonephritis,6 and potentially any pulmonary renal syndrome 7. DAH can also be idiopathic without any inflammatory process.…”