• JNMA J Nepal Med Assoc · Nov 2018

    Case Reports

    Diffuse Alveolar Haemorrhage as Initial Presentation of Systemic Lupus Erythematosus: A Case Report.

    • Ashesh Dhungana, Prajowl Shrestha, Bhakta Dev Shrestha, Anil Baral, and Gita Sayami.
    • Department of Medicine, National Academy of Medical Sciences, Kantipath, Kathmandu, Nepal.
    • JNMA J Nepal Med Assoc. 2018 Nov 1; 56 (214): 970-973.

    AbstractDiffuse 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.

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