Pulmonary hemorrhage (PH) is an uncommon clinical manifestation of patients with systemic lupus erythematosus (SLE). In this report, we describe a 14-year-old male with PH as the sole clinical manifestation of his SLE. Kidney biopsy was performed and the report revealed lupus nephritis class IVb. He demonstrated a rapid clinical response to the therapy of intravenous pulse methylprednisolone. Awareness of the possibility of PH as a sole clinical presentation of SLE may aid in the diagnosis and early aggressive management of this condition.
Leatherman JW , Davies SF , Hoidal JR . Alveolar hemorrhage syndromes: diffuse microvascular lung hemorrhage in immune and idiopathic disorders . Medicine (Balt) 1984; 63: 342–361 .
2.
Mintz G , Galindo LF , Fernandez-Diez J et al. Acute massive pulmonary hemorrhage in systemic lupus erythematosus . J Rheumatol1978; 5: 39–50 .
3.
Fukuda M , Kamiyama Y , Kawahara K et al. The favourable effect of cyclophosphamide pulse therapy in the treatment of massive pulmonary haemorrhage in systemic lupus erythematosus . Eur J Pediatr1994; 153: 167–170 .
4.
Cooper JAD Jr , White DA , Matthay RA . State of the art: drug-induced pulmonary disease . Am Rev Respir Dis1986; 133: 321–340 .
5.
Carette S , Macher AM , Nussbaum A et al. Severe acute pulmonary disease in patients with systemic lupus erythematosus: ten years of experience at the National Institutes of Health . Semin Arthrit Rheum1994; 14: 52–59 .
6.
Haput HM , Moore GW , Hutchins GM . The lung in systemic lupus erythematosus . Am J Med1981; 71: 791–798 .
7.
Brasington RD , Furst DE . Pulmonary disease in systemic lupus erythematosus . Clin Exp Rheumatol1985; 3: 269–276 .
8.
Zamora MR , Warner ML , Tuder R et al. Diffuse alveolar hemorrhage and systemic lupus erythematosus: clinical presentation, histology, survival and outcome . Medicine1997; 76: 192–202 .
9.
Myers JL , Katzenstein A . Microangitis in lupus induced pulmonary hemorrhage . Am J Clin Pathol1986; 85: 552–556 .
10.
Churg A , Franklin W , Chan K et al. Pulmonary hemorrhage and immune complex deposition in the lung . Arch Pathol LabMed1980; 104: 388–391 .
11.
Eagen JW , Memoli V , Robert J et al. Pulmonary hemorrhage in systemic lupus erythematosus . Medicine1978; 57: 545–560 .
12.
Liu MF , Lee JH , Weng TH et al. Clinical experience of 13 cases with severe pulmonary hemorrhage in systemic lupus erythematosus with active nephritis . Scand J Rheumatol1998; 27: 291–295 .
13.
Erickson RW , Franklin WA , Emlen W . Treatment of hemorrhagic lupus pneumonitis with plasmapharesis . Semin Arthrit Rheum1994; 24: 114–123 .
