Diffuse alveolar Hemorrhage as the initial presentation of systemic lupus erythematosus in a 57-year-old patient: a case report

TL;DR

A 57-year-old woman was diagnosed with lupus after presenting with a rare and severe lung condition called diffuse alveolar hemorrhage.

Contribution

This case highlights the rare initial presentation of SLE as diffuse alveolar hemorrhage and emphasizes the need for prompt diagnosis.

Findings

The patient presented with dyspnea and hemoptysis, leading to the diagnosis of DAH.

High-resolution CT scans showed diffuse bilateral infiltrates consistent with DAH.

The case revealed previously undiagnosed systemic lupus erythematosus.

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune systemic disease that presents a diagnostic challenge due to a wide range of clinical manifestations affecting multiple organs. Particularly rare is its presentation with diffuse alveolar hemorrhage (DAH), a severe complication that arises from the disruption of the capillary-alveolar barrier and can rapidly progress to a life-threatening condition.

We report a case of a 57-year-old female who presented to the emergency department experiencing dyspnea and hemoptysis. Her initial evaluations revealed anemia and thrombocytopenia, with high-resolution computed tomography scans showing diffuse bilateral infiltrates indicative of DAH. The findings led to the diagnosis of previously unrecognized SLE. This case underscores the importance of considering SLE in the differential diagnosis of DAH, emphasizing the necessity for prompt diagnostic workup and aggressive treatment in such critical presentations to improve patient outcomes.

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