<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2413-4341</journal-id>
<journal-title><![CDATA[Revista Paraguaya de Reumatología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. parag. reumatol.]]></abbrev-journal-title>
<issn>2413-4341</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Reumatología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2413-43412019000100027</article-id>
<article-id pub-id-type="doi">10.18004/rpr/2019.05.01.27-32</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hemorragia alveolar como forma de debut de lupus eritematoso sistémico]]></article-title>
<article-title xml:lang="en"><![CDATA[Alveolar hemorrhage as a form of systemic lupus erythematosus debut]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jarolin]]></surname>
<given-names><![CDATA[Dora Montiel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sobarzo]]></surname>
<given-names><![CDATA[Patricia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Nacional de Itaugua Departamento de Medicina Interna. ]]></institution>
<addr-line><![CDATA[Itauguá ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>5</volume>
<numero>1</numero>
<fpage>27</fpage>
<lpage>32</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2413-43412019000100027&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2413-43412019000100027&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2413-43412019000100027&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Introducción: La hemorragia alveolar difusa (HAD) sigue siendo una complicación pulmonar poco frecuente del lupus eritematoso sistémico (LES), pero potencialmente mortal me parece que así quedaría mejor. Objetivo: presentar las características clínicas, tratamiento y la evolución de dos pacientes con LES con hemorragia alveolar y nefritis lúpica asociada como forma de debut del LES material y método: serie de dos casos de pacientes con diagnóstico de LES con hemorragia alveolar difusa como forma de debut del LES, internadas en el Departamento de Medicina Interna del Hospital Nacional de Itaugua en el periodo 2007-2018. Resultados: de 500 pacientes con LES en seguimiento, 2 mujeres presentaron hemorragia alveolar como forma de debut del LES (0,4%), edad media 22 años ± 4,2., tiempo de enfermedad media de 60 días ± 42,4. Ambas pacientes presentaron disnea, fiebre, hemoptisis, disminución de la Hb, infiltrado pulmonar bilateral en la Radiografía de tórax, nefritis, insuficiencia respiratoria aguda, asistencia respiratoria mecánica (ARM). Solo una paciente se realizó biopsia renal, NL clase 3/C. Así mismo las dos pacientes recibieron pulsos de metilprednisolona 1g/d/3 días, seguidas de ciclofosfamida, con buena respuesta al tratamiento en una paciente y un óbito en la otra paciente. Comentario: Ambas debutaron con HAD, presentaron nefropatía asociada y necesidad de asistencia respiratoria mecánica. El óbito se presentó en la paciente con nefropatía e insuficiencia renal aguda.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT 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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[lupus eritematoso sistémico]]></kwd>
<kwd lng="es"><![CDATA[hemorragia alveolar]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="en"><![CDATA[Systemic lupus erythematosus]]></kwd>
<kwd lng="en"><![CDATA[alveolar hemorrhage]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
</kwd-group>
</article-meta>
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