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  • Title: Diffuse alveolar hemorrhage in lupus nephritis complicated by microscopic polyangiitis.
    Author: Isono M, Araki H, Haitani T, Morita Y, Yasuda M, Kato N, Urasaki K, Tsujimura Y.
    Journal: Clin Exp Nephrol; 2011 Apr; 15(2):294-8. PubMed ID: 21225308.
    Abstract:
    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.
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