Diffuse alveolar hemorrhage in lupus nephritis complicated by microscopic polyangiitis

作者：Isono Motohide^*; Araki Hisazumi; Haitani Takao; Morita Yoshikata; Yasuda Mako; Kato Noriko; Urasaki Koji; Tsujimura Yoshinori

来源：Clinical and Experimental Nephrology, 2011, 15(2): 294-298.

DOI：10.1007/s10157-010-0394-9

• Diffuse alveolar hemorrhage
• Lupus nephritis
• MPO-ANCA
• SLE

Diffuse alveolar hemorrhage (DAH) is a rare but fatal complication in patients with systemic lupus erythematosus (SLE). We describe a case of a 74-year-old woman who presented with DAH as an initial presentation of SLE. She also had microscopic polyangiitis clinically manifesting as crescentic glomerulonephritis and purpura with positive myeloperoxidase (MPO)-antineutrophil cytoplasmic antibodies (ANCA). The patient transiently improved when treated with plasma exchange and methylprednisolone pulse therapy; however, she died of recurrent pulmonary hemorrhage and concurrent cryptococcal pneumonia. This case indicates that MPO-ANCA is associated with severe organ involvement such as pulmonary hemorrhage and crescentic glomerulonephritis in SLE.

• 出版日期2011-4