• Ali Alsuheel Asseri, Raneem Al-Murayeh, Abdoh M Abudiah, Elsayed I Elgebally, and Abdullah M Aljaser.
• Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia.
• Medicine (Baltimore). 2022 Aug 19; 101 (33): e30071e30071.

RationaleDiffuse alveolar hemorrhage (DAH) is a rare manifestation of childhood systemic lupus erythematosus (SLE) that can be life-threatening. Several reports have linked previous or concurrent coronavirus disease (COVID-19) infections with a high prevalence of autoimmune and autoinflammatory disorders.Patient ConcernsWe report a case of a 13-year-old female who presented with DAH due to SLE 2 months after a laboratory-confirmed severe COVID-19 infection.DiagnosesThe patient was diagnosed with DAH due to SLE 2 months after a laboratory-confirmed severe COVID-19 infection.Interventions And OutcomesThe patient was treated with intravenous methylprednisolone pulse, broad-spectrum antibiotics, and supportive measures. In addition, she received 6 sessions of plasma exchange and maintenance methylprednisolone therapy (2 mg/kg/day). The patient then improved and was discharged on prednisolone, hydroxychloroquine, and azathioprine.LessonsWe suggest plasmapheresis be considered a treatment for SLE-associated DAH in the context of active disease when conventional treatment has failed to induce a rapid response. In addition, further studies are needed to assess the role of COVID-19 as an autoimmune disease trigger, particularly for SLE.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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