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Volume 33, Issue 1, March 2022



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Mediterr J Rheumatol 2022;33(1):81-7
Diffuse Alveolar Hemorrhage as a Life-Threatening Feature of Juvenile Onset Systemic Lupus Erythematosus: A Case-Based Review
Authors Information

1Department of Pediatrics Division of Nephrology & Rheumatology, İzmir Katip Çelebi University, İzmir, Turkey

2Department of Pediatrics, Health Sciences University İzmir Tepecik Training and Research Hospital, İzmir, Turkey

3Division of Hematology, Health Sciences University İzmir Tepecik Training and Research Hospital Department of Pediatrics, İzmir, Turkey
4Department of Pediatrics Division of Pediatric Intensive Care, İzmir Katip Çelebi University, İzmir, Turkey

B Kasap-Demir, G Bayram, Z Önder-Siviş, B Güneş-Tatlı, AB Anıl

Abstract

Diffuse alveolar hemorrhage is an uncommon but serious complication of systemic lupus erythematosus (SLE). We reported a 17-year-old boy with idiopathic thrombocytopenic purpura, who admitted with pallor and petechiae. He had Coombs positive hemolytic anemia and thrombocytopenia (hemoglobin 6.2g/dL, platelets 10,000/mm3 and lactate dehydrogenase 1024U/L), cough, tachypnea, and desaturation in the room air. Chest radiograph revealed bilateral diffuse alveolar opacities and computed tomography showed bilateral diffuse alveolar infiltrates and ground-glass opacity consistent with pulmonary hemorrhage. Anti-nuclear antibody (ANA) was 1:640 with positive Ro and anti-phospholipid antibodies, low C3 and C4, but negative anti-double-stranded DNA. He was treated with pulse methylprednisolone followed by tapering doses of steroids and with 6 doses of intravenous cyclophosphamide once every two weeks followed by mycophenolate mofetil. He had no relapse in the following 3 years. The case was reported to emphasise this life-threatening complication of juvenile-onset SLE and we reviewed the literature.

Cite this article as: Kasap-Demir B, Bayram G, Önder-Siviş Z, Güneş-Tatlı B, Anıl AB. Diffuse Alveolar Hemorrhage as a Life-Threatening Feature of Juvenile Onset Systemic Lupus Erythematosus: A Case-Based Review. Mediterr J Rheumatol 2022;33(1):81-7.

Article Submitted: 14 Sep 2020; Revised Form: 25 May 2021; Article Accepted: 30 May 2021; Available Online: 31 Mar 2022

https://doi.org/10.31138/mjr.33.1.81

This work is licensed under a Creative Commons Attribution 4.0 International License.

©Kasap-Demir B, Bayram G, Önder-Siviş Z, Güneş-Tatlı B, Anıl AB.