title: Diffuse alveolar hemorrhage as an initial presentation of systemic lupus erythematosus.
abstract: Diffuse alveolar hemorrhage is a rare but fatal complication in patients with systemic lupus erythematosus. It has rarely been reported to occur as the initial presentation in lupus patients. We report a 55-year-old female Jehovah's witness who presented with diffuse alveolar hemorrhage as the initial manifestation of systemic lupus erythematosus. She responded favorably to early intravenous pulse methylprednisolone and cyclophosphamide along with hemotherapy she accepted once over the course of her hospital stay. Initially, there was clinical improvement, but relapsing of her alveolar hemorrhage 15 days later. It is important to keep in mind that lupus patients can present initially with this lethal pulmonary complication. Early identification and initiation of therapy are crucial in order to affect survival of these patients.
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA. mateo.porres@ttuhsc.edu
authors.forename: Mateo
authors.initials: M
authors.lastname: Porres-Aguilar
authors.forename: Jose
authors.initials: J
authors.lastname: Mendez-Ramirez
authors.forename: Luis H
authors.initials: LH
authors.lastname: Eraso
authors.forename: Mateo
authors.initials: M
authors.lastname: Porres-Munoz
authors.forename: Kanchan
authors.initials: K
authors.lastname: Pema
mesh_terms: D017809:Fatal Outcome; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography