Pulmonary involvement in childhood-onset systemic lupus erythematosus: a report of five cases

Çıftçı, Ergın; Yalçınkaya, Fatma Fatoş; İnce, Elif; Ekı̇m, Mesı̇ha; İleri, Mehmet; Orgerin, Z; Fítöz, Suat; Güriz, Haluk; Aysev, Derya; Doğru, Ülker

doi:10.1093/rheumatology/keh120

Cited by 57 publications

(61 citation statements)

References 33 publications

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“…7 Pulmonary manifestations of SLE can include a wide spectrum of diseases such a pleuritis, pneuomonia, pulmonary embolism, pneumothorax and pulmonary hemorrhage. 8,9 Pulmonary hemorrhage is a rare and catastrophic complication in patients with SLE. Its frequency ranges from <2 to 4.7% in lupus patients.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Hemorrhage as the Initial Manifestation in Systemic Lupus Erythematosus with Active Nephritis: Case Report

Çildağ¹,

Şentürk²,

Yücetürk³

2012

Turkiye Klinikleri J Med Sci

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ulmonary hemorrhage (PH) is a rare and frequently fatal condition with mortality rates as high as 50-90%.1-3. The occurrence of massive PH as the initial and sole clinical manifestation of systemic lupus erythematosus (SLE) with active nephritis has rarely been reported.4,5 Treatment of PH in SLE remains controversial because no randomized trials are available. The experience from a number of case series suggests that high dosage of pulse corticosteroids with plasmapheresis, cyclophosphamide (CP) or both improves survival.1,6. We report a 50-year-old male with PH as the initial clinical manifestation of SLE, who had clinical response to early aggressive pulse methylprednisolone and CP therapy but whose PH relapsed later. Case ReportA AB BS ST TR RA AC CT T Pulmonary hemorrhage is the most devastating pulmonary complication of systemic lupus erythematosus. It has rarely been reported to occur as the initial presentation in lupus patients.We report a 50-year-old male who presented with pulmonary hemorrhage and nephritis as the initial manifestation of systemic lupus erythematosus. He presented with dyspnea, hemoptysis and pretibial edema. He responded to early intravenous pulse methylprednisolone therapy and cyclophosphamide therapy, but his pulmonary hemorrhage relapsed 20 days later. He was given intravenous methylprednisolone, intravenous cyclophosphamide and 5 sessions of plasmapheresis, resulting in temporal stabilization of his condition. Pulmonary hemorrhage in this connective tissue disease is an uncommon but serious complication with high mortality rates in spite of intensive treatment.K Ke ey y W Wo or rd ds s: : Systemic lupus erythematosus; lung diseases; lupus nephritis Ö ÖZ ZE ET T Pulmoner hemoraji sistemik lupus eritematozusun en yıkıcı pulmoner komplikasyonudur. Lupus hastalarında ilk bulgu olarak pulmoner hemorajinin görülmesi nadir olarak bildirilmiştir. Biz, sistemik lupus eritematozusun ilk bulgusu olarak pulmoner hemoraji ve nefrit ile gelen 50 yaşında bir erkek hastayı sunduk. Hasta, dispne, hemoptizi ve pretibial ödemle başvurdu. Erken intravenöz pals metilprednizolon tedavisine ve siklofosfamid tedavisine yanıt verdi fakat pulmoner hemorajisi 20 gün sonra tekrarladı. İntravenöz metilprednizolon, intravenöz siklofosfamid ve 5 seans plazmaferez verildi, durumunda geçici bir düzelme gözlendi. Bu bağ doku hastalığında pulmoner hemoraji yoğun tedaviye rağmen yüksek mortalite hızı olan, sık görülmeyen fakat ciddi bir komplikasyondur.A An na ah ht ta ar r K Ke el li im me el le er r: : Sistemik lupus eritematozus; akciğer hastalıkları; lupus nefriti T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J M Me ed d S Sc ci i 2 20 01 12 2; ;3 32 2( (4 4)

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Section: Discussionmentioning

confidence: 99%

Pulmonary Hemorrhage as the Initial Manifestation in Systemic Lupus Erythematosus with Active Nephritis: Case Report

Çildağ¹,

Şentürk²,

Yücetürk³

2012

Turkiye Klinikleri J Med Sci

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“…Pulmonary manifestations of SLE can include a wide spectrum of diseases such as pleuritis, pneumonia, pulmonary embolism, pneumothorax and pulmonary haemorrhage (1,2). Only few cases of non-infectious fulminant lupus pneumonitis (LP) mimicking, atypical pneumonia have been presented in literature to date.…”

Section: S Ystemic Lupus Erythematosus (Sle)mentioning

confidence: 99%

Systemic lupus erythematosus presenting as fulminant lupus pneumonitis: a rare case report

et al. 2016

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summaryWe report a case of 19 year-old female patient diagnosed as systemic lupus erythematosus (SLE) presented with fever and diffuse cutaneous lesions. During the hospital stay she had acute pneumonia, pleural effusion and respiratory failure, which required intensive care unit (ICU) care and mechanical ventilator support. A fulminant course of the disease, decreased values of complement levels and positive antinuclear antibodies (ANA) in pleural fluid and repeated negative sputum for acid-fast bacillus, blood cultures enabled diagnosis of fulminant lupus pneumonitis. Fulminant lupus pneumonitis is a rare but potentially life threatening complication of SLE. Management requires involvement of multiple specialties and rigorous efforts in reviving the patient.

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“…Lupus pneumonitis (LP) is an unusual and life threatening complication of SLE usually occurring during SLE flare-ups, but rarely as a presenting feature. Acute LP may mimic tuberculosis or other acute infectious pneumonia and its incidence varies from 0.9% to 11.7% [3]. Hence a high index of clinical suspicion should be kept, when young females present with unexplained pulmonary infiltrates, especially in tuberculosis endemic countries like India where use of empirical antitubercular therapy is high.…”

Section: Introductionmentioning

confidence: 99%

Lupus Pneumonitis Masquerading as Pulmonary Tuberculosis–A Case Study

Bhattacharya¹,

Roy²,

Jamil³

et al. 2015

J Arthritis

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Arthritis J o u rn al of Ar th r it is ISSN: 2167-7921Bhattacharya et al., J Arthritis 2015, 4:4 http://dx.doi. org/10.4172/2167-7921.1000171 Keywords: Systemic lupus erythematosus; Lupus pneumonitis; Pulmonary tuberculosis; Differential diagnosis Introduction SLE (Systemic lupus erythematosus) is a multisystem autoimmune disorder which has a waxing and waning course. The clinical manifestations of SLE are variable. They include erythematous photosensitive malar rash, oral ulcers, non-erosive polyarthritis or polyarthralgia, polyserositis, immune-mediated cytopenias, renal, neurologic, pulmonary and cardiac abnormalities. Pulmonary manifestations of SLE were first described by Osler in 1904 who described a patient of SLE with persistent lower lobe infiltrates [1]. A wide spectrum of pulmonary presentations has since been described, which include as pleuritis, pneumonia, pulmonary embolism, pneumothorax and pulmonary haemorrhage [2]. Though infections are a frequent cause of pulmonary infiltrates in patients with SLE, in many cases pulmonary infiltrates are not related to infection [1]. Lupus pneumonitis (LP) is an unusual and life threatening complication of SLE usually occurring during SLE flare-ups, but rarely as a presenting feature. Acute LP may mimic tuberculosis or other acute infectious pneumonia and its incidence varies from 0.9% to 11.7% [3]. Hence a high index of clinical suspicion should be kept, when young females present with unexplained pulmonary infiltrates, especially in tuberculosis endemic countries like India where use of empirical antitubercular therapy is high. We hereby report a case of LP as a presenting feature of SLE, thereby mimicking pulmonary tuberculosis. Case ReportAn 18 years old female was admitted to the hospital with complaints of low grade fever for 2 months, cough with mucoid expectoration for 3 weeks, blood streaked sputum for 1 week and difficulty in breathing for three days prior to admission. She had a history of swelling of hands and feet, off and on, for the past one year although she denied any specific history of joint pain. There was history of irregular menstruation and loss of hair. There was no history of palpitations, breathlessness, weight loss, or exposure to any drugs or toxins. She also gave history of contact with a case of pulmonary tuberculosis in her family. Past medical history was unremarkable and there was no history of travel in the recent past. Her bowel and bladder habits were normal.On examination she was fully conscious and oriented. Her blood pressure was 100/60 mm of Hg. She had tachycardia (pulse rate 106/ min), tachypnoea (respiratory rate -26/min) with dyspnoea, as evidenced by the use of accessory muscles of respiration, fever (oral temperature of 101 0 F). There was presence of pallor and grade-1 diffuse alopecia. On respiratory examination, there were diffuse bilateral coarse crepitations over her chest. Cardiac examination revealed a grade II soft systolic murmur with a prominent pulmonary component AbstractIntroduction: Systemic Lupus...

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Pulmonary involvement in childhood-onset systemic lupus erythematosus: a report of five cases

Cited by 57 publications

References 33 publications

Pulmonary Hemorrhage as the Initial Manifestation in Systemic Lupus Erythematosus with Active Nephritis: Case Report

Pulmonary Hemorrhage as the Initial Manifestation in Systemic Lupus Erythematosus with Active Nephritis: Case Report

Systemic lupus erythematosus presenting as fulminant lupus pneumonitis: a rare case report

Lupus Pneumonitis Masquerading as Pulmonary Tuberculosis–A Case Study

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