Abstract

JAROLIN, Dora Montiel  and  SOBARZO, Patricia. Alveolar hemorrhage as a form of systemic lupus erythematosus debut. Rev. parag. reumatol. [online]. 2019, vol.5, n.1, pp.27-32. ISSN 2413-4341.  https://doi.org/10.18004/rpr/2019.05.01.27-32.

Introduction: Introduction: Diffuse alveolar hemorrhage (DAH) is a rare and potentially fatal manifestation of systemic lupus erythematosus (SLE). Objective: to present the clinical characteristics, treatment and mortality of two patients with diffuse alveolar hemorrhage as the initial manifestation of SLE. Materials and methods: case series of two patients with diffuse alveolar hemorrhage as the initial manifestation of SLE, hospitalized in the Department of Internal Medicine of the National Hospital of Itaugua between 2007-2018. Results: of 500 patients with SLE, 2 women (0,4%) presented with alveolar hemorrhage as the initial manifestation of disease. The average age was 22 years, and average disease duration was 60 ± 42,4 days. All patients presented dyspnea, fever, hemoptysis, decrease in Hb, bilateral pulmonary infiltrates on chest X-ray, nephritis, and acute respiratory failure with mechanical ventilation (ARM) requirement. One of the two patients had renal failure. Both patients were treated with intravenous pulses of methylprednisolone (1g for 3 days) and cyclophosphamide. One patient required hemodialysis. One patient had a kidney biopsy which confirmed a class III/C nephritis. One patient had good response to treatment and one patient died. Comment: Both patients presented with DAH, associated nephropathy and need for mechanical ventilation. Death occurred in the patient with nephropathy and acute renal failure.

Keywords : Systemic lupus erythematosus; alveolar hemorrhage; mortality.

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