title: Diffuse alveolar hemorrhage as an unusual presentation of systemic lupus erythematosus.
abstract: Diffuse alveolar hemorrhage (DAH) is rarely seen in patients with systemic lupus erythematosus (SLE), often associated with a poor outcome. It almost affects young women and it is an unusual initial manifestation of SLE. We report a case of SLE presenting with DAH. The patient was a male. He had no history of photosensitivity, malar rash, discoid rash, arthritis, and oral ulcer. Antinuclear antibody, and anti-double stranded DNA (dsDNA) were positive with very high titers, and serum complement levels (C3, C4) were low. He also had renal dysfunction and pericardial effusion. He was diagnosed as DAH due to SLE. He had to undergo hemodialysis for several weeks. DAH and renal dysfunction were improved with intensive treatment including corticosteroid, cyclophosphamide, and mycophenolate mophetil.
authors.affiliation: Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey. dr.erkansengul@hotmail.com
authors.forename: Erkan
authors.initials: E
authors.lastname: Sengul
authors.forename: Tayfun
authors.initials: T
authors.lastname: Eyıleten
authors.forename: Ayhan
authors.initials: A
authors.lastname: Ozcan
authors.forename: Mahmut Ilker
authors.initials: MI
authors.lastname: Yılmaz
authors.forename: Mujdat
authors.initials: M
authors.lastname: Yenıcesu
mesh_terms: D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use; D006470:Hemorrhage / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011650:Pulmonary Alveoli / Q000473:pathology*; D006435:Renal Dialysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D009173:Mycophenolic Acid