title: Clinical characteristics and outcomes of diffuse alveolar hemorrhage in patients with systemic lupus erythematosus.
abstract: To identify the clinical characteristics of diffuse alveolar hemorrhage (DAH) compared to other types of acute diffuse lung infiltration in SLE patients, and the factors associated with mortality in these patients.
  
  
  
  We studied a retrospective cohort including SLE patients with acute diffuse lung infiltration on thoracic CT between January 2004 and August 2014. We divided them into 2 groups, a DAH and a non-DAH group, and compared the clinical characteristics and outcomes in the 2 groups. We also evaluated the risk factors for mortality in SLE patients with diffuse lung infiltration.
  
  
  
  Of 47 patients with diffuse lung infiltration, 24 patients (51.1%) satisfied the criteria for DAH and the remaining 23 patients (48.9%) were assigned to the non-DAH group. There were no significant differences between the demographic features of the 2 groups. However, decreased hemoglobin (OR = 3.46; 95% CI: 1.38-8.67; p < 0.01) and C4 (OR = 1.21; 95% CI: 1.03-1.42; p = 0.02) levels, and presence of hypoxia (OR = 23.09; 95% CI: 1.47-365.34; p = 0.03) at the time of diagnosis were associated with SLE-DAH. In addition, severe conditions requiring mechanical ventilation (OR = 64.61; 95% CI: 1.98-2112.02; p = 0.02) were associated with increased mortality, whereas DAH did not increase mortality compared with non-DAH in SLE patients with diffuse lung infiltration.
  
  
  
  In SLE patients with acute diffuse lung infiltration, it is important to promptly evaluate the DAH when patients have low levels of hemoglobin or C4, and symptoms of hypoxia. Mortality is associated with severe conditions requiring mechanical ventilation rather than with DAH in patients with diffuse lung infiltration.
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, South Korea.
authors.forename: Dam
authors.initials: D
authors.lastname: Kim
authors.affiliation: Department of Rheumatology, Hanmaeum Hospital, Hanyang Medical Center, Chan-won, South Korea.
authors.forename: Jeongim
authors.initials: J
authors.lastname: Choi
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, South Korea.
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Cho
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, South Korea.
authors.forename: Chan-Bum
authors.initials: CB
authors.lastname: Choi
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, South Korea.
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, South Korea.
authors.forename: Jae-Bum
authors.initials: JB
authors.lastname: Jun
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, South Korea.
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Yoo
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, South Korea.
authors.forename: Sang-Cheol
authors.initials: SC
authors.lastname: Bae
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, South Korea. Electronic address: sungyk@hanyang.ac.kr.
authors.forename: Yoon-Kyoung
authors.initials: YK
authors.lastname: Sung
mesh_terms: D000328:Adult; D003181:Complement C4 / Q000032:analysis; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006470:Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008171:Lung Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D003181:Complement C4; D006454:Hemoglobins
keywords: Hemorrhage; Lung; Lupus erythematosus, Systemic