title: [Pulmonary hemorrhage in patients with systemic lupus erythematosus. Clinical manifestations and prognosis].
abstract: OBJECTIVE
  Pulmonary hemorrhage (PH) in systemic lupus erythematosus (SLE) is a rare but potentially fatal complication that occurs most frequently in the context of active lupus with involvement of other organs. The objective of this study is to report the clinical features and prognosis of patients with SLE who had PH.
  
  
  METHODS
  Patients with SLE (1982 American College of Rheumatology criteria) and PH under monitoring between June 1999 and November 2011 were studied. Demographic, clinical, laboratory, treatment and prognosis data related to PH were analyzed.
  
  
  RESULTS
  Eleven patients with SLE developed 14 episodes of PH. PH was the first manifestation of SLE in 2 patients. The most frequent symptoms and clinical signs were dyspnea, fever and cough, which occurred in 12 (85%), 11 (77%) and 7 (50%) patients, respectively. Hemoptysis was also observed in 5 (35%) episodes, tachycardia in 2 (14%), pallor in one (7%) and chest pain in one (7%). All patients had other concomitant organ involvement, and were treated with glucocorticoids. In addition, intravenous cyclophosphamide was indicated in 12 episodes and plasma exchange in 4. Overall mortality was 64%. Factors associated with mortality were infection, mechanical ventilation and dialysis.
  
  
  CONCLUSIONS
  PH continues to be a rare and severe complication of SLE. Its suspected presence forces us to quickly study these patients, since early diagnosis and aggressive treatment have been shown to improve survival in them.
authors.affiliation: Sección de Reumatología, Hospital J. M. Cullen, Santa Fe, Argentina.
authors.forename: Pablo
authors.initials: P
authors.lastname: Finucci Curi
authors.affiliation: Sección de Reumatología, Hospital J. M. Cullen, Santa Fe, Argentina.
authors.forename: Matilde
authors.initials: M
authors.lastname: Pierrestegui
authors.affiliation: Sección de Reumatología, Hospital J. M. Cullen, Santa Fe, Argentina.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ortiz
authors.affiliation: Sección de Reumatología, Hospital J. M. Cullen, Santa Fe, Argentina.
authors.forename: Federico
authors.initials: F
authors.lastname: Ceccato
authors.affiliation: Sección de Reumatología, Hospital J. M. Cullen, Santa Fe, Argentina. Electronic address: pairasergio@fibertel.com.ar.
authors.forename: Sergio
authors.initials: S
authors.lastname: Paira
mesh_terms: D000293:Adolescent; D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000209:etiology; D006470:Hemorrhage / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008171:Lung Diseases / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide
keywords: Clinical manifestations; Hemorragia pulmonar; Lupus eritematoso sistémico; Manifestaciones clínicas; Prognosis; Pronóstico; Pulmonary hemorrhage; Systemic lupus erythematosus