title: Pulmonary embolism in an adolescent girl with negative ACLA systemic lupus erythematosus (SLE): a case report.
abstract: Pulmonary involvement is a common manifestation in systemic lupus erythematosus (SLE), whereas pulmonary thromboembolism (PTE) is rarely seen in SLE. PTE related to anti-phospholipid antibody syndrome (APS) is also a rare disease. We have reported a 13-year-old female diagnosed with SLE Two years ago, who is being treated with hydroxychloroquine and prednisolone. She presented with shortness of breath, dry cough, and fever about two weeks prior to admission. She was initially admitted with the diagnosis of pneumonia, but no clinical improvement was seen she was given antibiotics. Hemoptysis was added to her symptoms, so spiral high resolution computed tomography (HRCT) of the lungs was requested, and it indicated patchy consolidations bilaterally. With suspicion of pulmonary thromboembolism (PTE), spiral computed tomography angiography of pulmonary vessels was done, revealing PTE. After initiation of anti-coagulants, her clinical condition and respiratory status improved significantly. We present a rare case of SLE where only lupus anti-coagulant test was abnormal while other tests, such as anti-cardiolipin antibody and anti-phospholipid antibody were normal. Therefore, we can conclude that clinical suspicion had the main role in diagnosis in our case, as it has in medicine.
authors.affiliation: M.D., Professor, Department of Immunology and Allergy, Faculty of Medicine, Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Seyed Hesamedin
authors.initials: SH
authors.lastname: Nabavizadeh
authors.affiliation: M.D., Faculty Member, Department of Pediatrics, Faculty of Medicine, Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Nazanin
authors.initials: N
authors.lastname: Farahbakhsh
authors.affiliation: M.D., Faculty Member, Department of Immunology and Allergy, Faculty of Medicine, Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Fazel
authors.affiliation: M.D., Faculty Member, Department of Immunology and Allergy, Faculty of Medicine, Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Houshmand
authors.affiliation: M.D., Faculty Member, Department of Internal Medicine, Faculty of Medicine, Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Anushiravani
keywords: ACLA; pulmonary thromboembolism; systemic lupus erythematosus (SLE)