Dramatic efficacy of cyclophosphamide pulsed therapy combined with double–filtration plasmapheresis for treating severe massive pulmonary hemorrhage associated with systemic lupus erythematosus

2002 ◽  
Vol 12 (4) ◽  
pp. 357-361
Author(s):  
T. Ito ◽  
K. Inose ◽  
S. Horie ◽  
Y. Okubo ◽  
R. Yoshida ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Pulmonary Hemorrhage ◽  
Systemic Lupus ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration

Double Filtration Plasmapheresis in a Patient with Autoimmune Hepatitis-Systemic Lupus Erythematosus Overlap.

1993 ◽  
Vol 32 (9) ◽  
pp. 725-729 ◽  
Author(s):  
Kimihiro SUZUKI ◽  
Yasunori MATSUKI ◽  
Toshihiko HIDAKA ◽  
Yasushi KAWAGUCHI ◽  
Makoto KAWAKAMI ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Autoimmune Hepatitis ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Double Filtration Plasmapheresis ◽  
Double Filtration

scholarly journals Pulmonary hemorrhage as a manifestation of systemic lupus erythematosus

2004 ◽  
Vol 59 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Bruno Hollanda Santos ◽  
Rodrigo Ribeiro Santos ◽  
Celeide Fátima Santos ◽  
Adriana Maria Kakehasi ◽  
Hermann Alexandre Vivacqua Von Tiesenhausen
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Pulmonary Hemorrhage ◽  
Pulse Therapy ◽  
Loss Of Consciousness ◽  
Systemic Lupus ◽  
Sudden Loss ◽  
American College Of Rheumatology ◽  
High Level

The authors report a case of a 19-year-old woman admitted for the investigation of fever and hemolytic anemia for the previous 2 months. As an inpatient, she had convulsions and sudden loss of consciousness, developing hemoptysis, hypoxia, and respiratory insufficiency. Examination showed pericardial effusions on the echocardiogram and bilateral alveolar condensations on the thoracic radiograph. A hypothetical diagnosis of systemic lupus erythematosus was made, and measurement of the antinuclear factor was requested along with daily pulse therapy methylprednisolone, in spite of which the outcome was fatal. Afterwards, the result of the antinuclear factor test was positive, with a titer of 1:5120, showing a fine punctiform pattern, fulfilling the criteria for systemic lupus erythematosus according to the American College of Rheumatology. Secondary pulmonary hemorrhage in this connective tissue disease is an uncommon but serious complication that involves a high level of mortality in spite of intensive treatment, as is also reported in the literature.

PULMONARY HEMORRHAGE IN SYSTEMIC LUPUS ERYTHEMATOSUS

Medicine ◽  
1978 ◽  
Vol 57 (6) ◽  
pp. 545 ◽  
Author(s):  
JEREMIAH W. EAGEN ◽  
VINCENT A. MEMOLI ◽  
JIMMY L. ROBERTS ◽  
GUY R. MATTHEW ◽  
MELVIN M. SCHWARTZ ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Pulmonary Hemorrhage ◽  
Systemic Lupus

scholarly journals Cytomegaloviral or Pneumocystis Jiroveci Pneumonia Increases Mortality in Systemic Lupus Erythematosus Patients with Pulmonary Hemorrhage: Evidence from Bronchoalveolar Lavage Fluid

2018 ◽  
Vol 46 (3) ◽  
pp. 251-258 ◽  
Author(s):  
Yi-Syuan Sun ◽  
De-Feng Huang ◽  
Fang-Chi Lin ◽  
Chih-Kai Hsu ◽  
I-Ting Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Bronchoalveolar Lavage ◽  
Lupus Erythematosus ◽  
Bronchoalveolar Lavage Fluid ◽  
Pulmonary Hemorrhage ◽  
Lavage Fluid ◽  
Mortality Rates ◽  
Systemic Lupus ◽  
Pneumocystis Jiroveci

Objective.To evaluate the role of cytomegaloviral or Pneumocystis jiroveci pneumonia (CMV/PJP) in systemic lupus erythematosus (SLE) patients with pulmonary hemorrhage (PH).Methods.We retrospectively examined hospital records for 27 SLE patients with PH who received bronchoalveolar lavage fluid (BALF) analyses. Clinical profile and mortality rates were compared between groups with and without CMV/PJP. Risk factors for PH-related mortality were analyzed.Results.Among 27 SLE patients with PH, 15 had pathogens from BALF samples, and 8 had CMV/PJP. Although CMV/PJP was treated, the RR for 90- and 180-day mortality rates of SLE patients with CMV/PJP were higher than those without these infections (5.94, 95% CI 1.44–24.48; 7.13, 95% CI 1.81–28.06, respectively). Risk factors for 90- and 180-day mortality were presence of CMV/PJP (OR 14.2, 95% CI 1.83–109.9; OR 25.5, 95% CI 2.91–223.3, respectively) and use of pulse methylprednisolone for PH treatment (OR 12.0, 95% CI 1.48–97.2; OR 8.5, 95% CI 1.13–63.9, respectively). Factors increasing the 90-day mortality rate were duration of mechanical ventilation exceeding 14 days (OR 11.1, 95% CI 1.11–112.0) and use of aggressive immunosuppression close to PH onset (OR 7.56, 95% CI 1.09–52.4). Three of the 7 patients receiving aggressive immunosuppression died with the presence of CMV/PJP.Conclusion.Owing to the high prevalence of CMV/PJP and its association with mortality, routine BALF analysis is recommended for all suitable SLE patients with PH. Use of aggressive immunosuppression does not benefit SLE patients with opportunistic infections during PH attack.

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