系统性红斑狼疮(SLE)是一种自身免疫性疾病,以II型和III型超敏反应为特征,影响多个器官,包括关节,心,肺,大脑,皮肤,还有肾脏.SLE患者会出现一系列症状,从发烧和关节痛到独特的蝴蝶面部皮疹。严重的并发症可能包括弥漫性肺泡出血(DAH),肺动脉高压,和狼疮性肾炎,在其他人中。其中,DAH,严重的SLE肺部并发症,涉及由于免疫复合物损伤引起的间质毛细血管和肺泡出血。此病例报告描述了最初被误诊但后来被证实患有SLE的患者。患者出现持续症状,包括咳嗽,呼吸困难,发烧,超过两周,随后在过去两天内出现血尿和咯血。症状的进展导致急性加重,导致她进入急诊科。随后的评估证实了狼疮性肾炎和DAH的诊断。此病例强调了在不明原因的全身症状的鉴别诊断中考虑SLE的重要性,并强调了迫切需要对DAH进行医疗干预以大大降低死亡率。
Systemic lupus erythematosus (
SLE) is an autoimmune disease characterized by type II and type III hypersensitivity reactions that affect multiple organs, including the joints, heart, lungs, brain, skin, and kidneys. Patients with
SLE can experience a range of symptoms, ranging from fever and joint pain to a distinctive butterfly facial rash. Severe complications may encompass conditions such as diffuse alveolar hemorrhage (DAH), pulmonary hypertension, and lupus nephritis, among others. Among them, DAH, a critical pulmonary complication in
SLE, involves bleeding from interstitial capillaries and alveoli due to immune complex damage. This
case report describes a patient who was initially misdiagnosed but later confirmed to have
SLE. The patient presented with persistent symptoms, including cough, dyspnea, and fever, over two weeks and subsequently developed hematuria and hemoptysis within the last two days. The progression of symptoms led to an acute exacerbation, resulting in her admission to the emergency department. Subsequent evaluations confirmed the diagnosis of lupus nephritis and DAH. This
case highlights the importance of considering
SLE in the differential diagnosis of unexplained systemic symptoms and underscores the urgent need for medical intervention in DAH to substantially reduce mortality.