Pulmonary hemorrhage as the initial manifestation in systemic lupus erythematosus with active nephritis: Case Report

Abstract

Pulmonary hemorrhage is the most devastating pulmonary complication of systemic lupus erythematosus. It has rarely been reported to occur as the initial presentation in lupus patients. We report a 50-year-old male who presented with pulmonary hemorrhage and nephritis as the initial manifestation of systemic lupus erythematosus. He presented with dyspnea, hemoptysis and pretibial edema. He responded to early intravenous pulse methylprednisolone therapy and cyclop-hosphamide therapy, but his pulmonary hemorrhage relapsed 20 days later. He was given intravenous methylprednisolone, intravenous cyclophosphamide and 5 sessions of plasmapheresis, resulting in temporal stabilization of his condition. Pulmonary hemorrhage in this connective tissue disease is an uncommon but serious complication with high mortality rates in spite of intensive treatment. © 2012 by Türkiye Klinikleri.