Diffuse Alveolar Haemorrhage as Initial Presentation of Systemic Lupus Erythematosus

Anil Baral,Ashesh Dhungana,Bhakta Dev Shrestha,Gita Sayami,Prajowl Shrestha

doi:10.31729/jnma.3903

Abstract

Diffuse alveolar hemorrhage results from accumulation of red blood cells in the alveolar space originating from alveolar capillaries. Alveolar hemorrhage in Systemic Lupus Erythematosus is rare but catastrophic and can rapidly progress to respiratory failure. We report a 22-year old lady who presented with dyspnoea on exertion, hemoptysis, bilateral leg swelling and oliguria. Diffuse alveolar hemorrhage was confirmed by bronchoalveolar lavage fluid analysis. Serologic tests and renal biopsy confirmed lupus nephritis. She was treated with systemic immunosuppressive therapy and plasma exchange, to which she had a favourable response. Lupus presenting as alveolar hemorrhage is rare which warrants prompt diagnosis and treatment to prevent complications. Keywords: Bronchoalveolar lavage; Case report; Diffuse alveolar hemorrhage; Systemic lupus erythematosus.

Highlights

Diffuse alveolar haemorrhage (DAH) results from accumulation of red blood cells originating from alveolar capillaries into the alveolar space.[1,2]
We hereby report a 22-year old lady who presented with DAH which was diagnosed by Bronchoalveolar Lavage (BAL)
Serological tests indicated presence of SLE and kidney biopsy confirmed presence of lupus nephritis. This case report highlights the importance of bronchoscopy and BAL in the diagnosis of DAH in appropriate clinical setting

Summary

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Diffuse Alveolar Haemorrhage as Initial Presentation of Systemic Lupus Erythematosus: A Case Report. Ashesh Dhungana,[1] Prajowl Shrestha,[1] Bhakta Dev Shrestha,[1] Anil Baral,[2] Gita Sayami[3]

INTRODUCTION

DISCUSSION