title: Infantile systemic lupus erythematosus presenting with pulmonary hemorrhage.
abstract: Systemic lupus erythematosus in infants born to healthy mothers is a rare entity. We describe a male infant who presented at 1 month of age with pulmonary hemorrhage and glomerulonephritis due to systemic lupus erythematosus, confirmed serologically and histologically. He was managed with a combination of prednisone and intermittent cyclophosphamide, but also received mycophenolate mofetil, with a complete serological and clinical remission at 30-month follow-up. This case underscores the importance of a broad approach to the evaluation of pulmonary hemorrhage and glomerulonephritis in the very young and the need for aggressive immunosuppressive therapy to achieve sustained serological and clinical remission.
authors.affiliation: Division of Pulmonology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pennsylvania, USA.
authors.forename: James
authors.initials: J
authors.lastname: Kreindler
authors.forename: Demetrius
authors.initials: D
authors.lastname: Ellis
authors.forename: Abhay
authors.initials: A
authors.lastname: Vats
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Kurland
authors.forename: Sarangarajan
authors.initials: S
authors.lastname: Ranganathan
authors.forename: Michael L
authors.initials: ML
authors.lastname: Moritz
mesh_terms: D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005921:Glomerulonephritis / Q000209:etiology / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D007668:Kidney / Q000473:pathology; D008171:Lung Diseases / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D011241:Prednisone
references.citation: Clin Nephrol. 1979 Sep;12(3):137-41
references.pmid: 389504
references.citation: Br J Dermatol. 1971 Feb;84(2):182-3
references.pmid: 5548471
references.citation: Arch Intern Med. 1987 May;147(5):891-5
references.pmid: 3034179
references.citation: J Pediatr. 1994 Jan;124(1):27-31
references.pmid: 8283373
references.citation: Lupus. 2001;10 (12 ):879-82
references.pmid: 11787879
references.citation: Arch Anat Cytol Pathol. 1989;37(4):177-80
references.pmid: 2818003
references.citation: Pediatr Pathol. 1987;7(1):1-18
references.pmid: 3601812
references.citation: J Rheumatol. 2001 Sep;28(9):2103-8
references.pmid: 11550982
references.citation: Pediatr Nephrol. 1998 Feb;12(2):136-8
references.pmid: 9543373
references.citation: Pediatr Nephrol. 2000 Dec;15(3-4):286-9
references.pmid: 11149128
references.citation: Pediatr Rev. 2002 Nov;23(11):371-80
references.pmid: 12415016
references.citation: J Clin Immunol. 1984 Mar;4(2):156-62
references.pmid: 6609934
references.citation: J Pediatr. 2000 Feb;136(2):243-7
references.pmid: 10657833
references.citation: N Engl J Med. 1986 Mar 6;314(10):614-9
references.pmid: 3511372