Acute reversible hypoxemia in systemic lupus erythematosus: a new syndrome or an index of disease activity?
In 1991, Abramson et al reported a new syndrome of acute reversible hypoxemia (ARH) in patients with severe SLE (systemic lupus erythematosus). This syndrome was characterized by an unexplained abnormal value of arterial blood gases (ABG) without obvious parenchymal lung disease, and a good response to high-dose corticosteroid therapy. After we became aware of this entity, four of 16 patients admitted to our unit because of a SLE flare presented respiratory symptoms and abnormal ABG consistent with ARH. In none of our patients were the pulmonary manifestations a prominent clinical feature of the disease. Furthermore, in two of them, treatment with high-dose aspirin and moderate to low doses of corticosteroids was sufficient to improve the pulmonary manifestations, but not to control the systemic activity of the disease. Therefore, we believe that this new pulmonary finding more than a clinically independent syndrome represents an index of disease activity in patients with SLE.
Rheumatology Division, Hospital Universitario M. Valdecilla, Facultad de Medicina, Universidad de Cantabria, Santander, Spain.
V M
VM
Martinez-Taboada
R
R
Blanco
J
J
Armona
J L
JL
Fernandez-Sueiro
V
V
Rodriguez-Valverde
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012720:Severity of Illness Index