Masoodi I, Sirwal IA, Anwar SK, Alzaidi A, Balbaid KA. Predictors of Mortality in Pulmonary Haemorrhage during SLE: A Single Centre Study Over Eleven Years.
Open Access Maced J Med Sci 2019;
7:92-96. [PMID:
30740168 PMCID:
PMC6352490 DOI:
10.3889/oamjms.2019.038]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/22/2018] [Accepted: 01/10/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND
Pulmonary haemorrhage (PH) is a serious complication during Systemic Lupus Erythematosus (SLE).
AIM
The aim was to present data on 12 patients of SLE with classic symptoms and signs of PH admitted throughout eleven years.
METHODS
This retrospective study was carried out at King Abdul Aziz Specialist hospital in Taif-a tertiary care hospital in the western region of Saudi Arabia. The data was analysed from the case files of SLE patients who had episodes of PH throughout 11 years (January 2007 to December 2017).
RESULTS
Twelve patients (10 females and 2 males) were found to have diffuse pulmonary haemorrhage during their SLE in the study period. Of 12 patients with confirmed pulmonary haemorrhage (hemoptysis, hypoxemia, new infiltrates on chest radiography, fall in haemoglobin and hemorrhagic returns of bronchoalveolar lavage with hemosiderin-laden macrophages) 4 patients had PH as the first presentation of SLE and 8 patients developed this complication during the disease. All patients presented with shortness of breath and hemoptysis. The most common extra-pulmonary involvement in the study cohort was renal (83%), which ranged from clinical nephritis, nephrotic syndrome to acute renal failure. All patients were managed in intensive care of the hospital, and of 12 patients, 9 (75%) required mechanical ventilation. All patients were uniformly treated with pulse Methylprednisolone; 9 received Cyclophosphamide, 6 received IVIG, and 4 received Plasmapheresis. Only 3 patients (25%) survived despite maximum possible support during their mean hospital stay of 18 ± 5 days.
CONCLUSION
The requirement of mechanical ventilation and the association of renal and neuropsychiatric complications predicted mortality in patients with pulmonary haemorrhage.
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