Antepartum Diagnosis and Treatment of Diffuse Alveolar Hemorrhage in a Pregnant Woman with Systemic Lupus Erythematosus

Ha Shin Kim; Hae Sun Jeon; Soo Jin Han; Ji Hoi Kim; Jae Hoon Chang; Kichul Shin; Byoung Jae Kim; Seung Mi Lee

doi:10.14734/PN.2019.30.1.32

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Kim, Jeon, Han, Kim, Chang, Shin, Kim, and Lee: Antepartum Diagnosis and Treatment of Diffuse Alveolar Hemorrhage in a Pregnant Woman with Systemic Lupus Erythematosus

Case Report

Perinatology 2019;30(1):32-35.

Published online: 20 March 2019

DOI: https://doi.org/10.14734/PN.2019.30.1.32

Antepartum Diagnosis and Treatment of Diffuse Alveolar Hemorrhage in a Pregnant Woman with Systemic Lupus Erythematosus

Ha Shin Kim, MD¹, Hae Sun Jeon, MD¹, Soo Jin Han, MD¹, Ji Hoi Kim, MD¹, Jae Hoon Chang, MD¹, Kichul Shin, MD^2,³, Byoung Jae Kim, MD^1,⁴, Seung Mi Lee, MD, PhD^1,

¹Department of Obstetrics and Gyne cology, Seoul National University College of Medicine, Seoul

²Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul

³Department of Internal Medicine, Seoul National University College of Medicine, Seoul

⁴Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea

Correspondence to Seung Mi Lee, MD, PhD Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea

Received 24 August 2018 Revised 9 October 2018 Accepted 10 October 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Diffuse alveolar hemorrhage (DAH) is a rare and life-threatening complication of systemic lupus erythematosus. Differential diagnosis and successful management of DAH can be problematic in pregnancy. We report a case of a 35-year-old pregnant woman who was presumptively diagnosed with DAH and treated during the antepartum period, resulting in symptomatic improvement and successful delivery after immunosuppressive treatment.

Keywords: Pregnancy complications, Lupus erythematosus, Systemic, Lupus nephritis, Hemorrhage, Lung diseases

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Fig. 1.

(A) Chest radiograph showing diffuse consolidation. (B) Chest computed tomography scan showing diffuse ground glass opacity and nodular consolidation.

Fig. 2.

Chest radiograph showing radiographic improvement.

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