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2 Cases of SLE-Associated Diffuse Alveolar Hemorrhage

Abhimanyu Amarnani, MD, PhD, Nicole K. Zagelbaum Ward, DO, MPH, Lauren Mathias, MD, Nathan Lim, MD, Baljeet Rai, MD, Sky Wang, MD, & William Stohl, MD, PhD  |  Issue: August 2021  |  August 12, 2021

Conclusion

SLE-associated DAH is not yet adequately understood. Multicenter studies to define ideal diagnosis and treatment strategies for patients are sorely needed. Prompt recognition of the disease, appropriate supportive therapy and informed immunosuppressive interventions improve outcomes for patients with SLE-associated DAH.


Abhimanyu Amarnani, MD, PhDAbhimanyu Amarnani, MD, PhD, is an internal medicine resident in the ABIM Research Pathway at Los Angeles County + University of Southern California Medical Center and the Keck School of Medicine, University of Southern California (USC), Los Angeles, and is pursuing a fellowship in rheumatology.

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Nicole K. Zagelbaum Ward, DO, MPHNicole K. Zagelbaum Ward, DO, MPH, is a second-year rheumatology fellow at the Keck School of Medicine, USC.

Lauren Mathias, MDLauren Mathias, MD, is an attending physician at PIH Health Hospital in Downey, Calif. Her interests include general rheumatology, musculoskeletal ultrasound and medical education.

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Nathan Lim, MDNathan Lim, MD, is a second-year rheumatology fellow at USC.

Baljeet Rai, MDBaljeet Rai, MD, is a third-year internal medicine resident at USC, pursuing a career in rheumatology.

Sky Wang, MDSky Wang, MD, is an attending physician in the Section of Rheumatology at the Rancho Los Amigos National Rehabilitation Center, Los Angeles.

William Stohl, MD, PhDWilliam Stohl, MD, PhD, is professor of medicine and chief of the Division of Rheumatology at the Keck School of Medicine, USC.

References

  1. Zamora MR, Warner ML, Tuder R, et al. Diffuse alveolar hemorrhage and systemic lupus erythematosus. Clinical presentation, histology, survival, and outcome. Medicine (Baltimore). 1997 May;76(3):192–202.
  2. Mintz G, Galindo LF, Fernández-Diez J, et al. Acute massive pulmonary hemorrhage in systemic lupus erythematosus. J Rheumatol. Spring 1978;5(1):39–50.
  3. Al-Adhoubi NK, Bystrom J. Systemic lupus erythematosus and diffuse alveolar hemorrhage, etiology and novel treatment strategies. Lupus. 2020 Apr;29(4):355–363.
  4. Marten K, Schnyder P, Schirg E, et al. Pattern-based differential diagnosis in pulmonary vasculitis using volumetric CT. AJR Am J Roentgenol. 2005 Mar;
    184(3):720–733.
  5. Jiang M, Chen R, Zhao L, et al. Risk factors for mortality of diffuse alveolar hemorrhage in systemic lupus erythematosus: A systematic review and meta-analysis. Arthritis Res Ther. 2021 Feb 16;23(1):57.
  6. Sun Y, Zhou C, Zhao J, et al. Systemic lupus erythematosus–associated diffuse alveolar hemorrhage: A single-center, matched case-control study in China. Lupus. 2020 Jun;29(7):795–803.
  7. Vilá-Rivera K, Jiménez-Encarnación E, Vilá S. Pulmonary hemorrhage in a patient initially presenting with discoid lupus. P R Health Sci J. 2013 Dec;32(4):203–205.
  8. Elman SA, Joyce C, Costenbader KH, et al. Time to progression from discoid lupus erythematosus to systemic lupus erythematosus: A retrospective cohort study. Clin Exp Dermatol. 2020 Jan;45(1):89–91.

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Filed under:ConditionsSystemic Lupus Erythematosus Tagged with:case reportdiffuse alveolar hemorrhage

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