Diffuse Alveolar Haemorrhage as Initial Presentation of Systemic Lupus Erythematosus

• Main Authors: Ashesh Dhungana, Prajowl Shrestha, Bhakta Dev Shrestha, Anil Baral, Gita Sayami
• Format: Article
• Language: English
• Published: Nepal Medical Association 2018-12-01
• Series: Journal of Nepal Medical Association
• Subjects: Bronchoalveolar lavage (BAL), Diffuse alveolar hemorrhage (DAH), Systemic lupus erythematosus (SLE)
• Online Access: https://www.jnma.com.np/jnma/index.php/jnma/article/view/3903

Diffuse alveolar hemorrhage results from accumulation of red blood cells in the alveolar space originating from alveolar capillaries. Alveolar hemorrhage in Systemic Lupus Erythematosus is rare but catastrophic and can rapidly progress to respiratory failure. We report a 22-year old lady who presented with dyspnoea on exertion, hemoptysis, bilateral leg swelling and oliguria. Diffuse alveolar hemorrhage was confirmed by bronchoalveolar lavage fluid analysis. Serologic tests and renal biopsy confirmed lupus nephritis. She was treated with systemic immunosuppressive therapy and plasma exchange, to which she had a favourable response. Lupus presenting as alveolar hemorrhage is rare which warrants prompt diagnosis and treatment to prevent complications.