Combination therapy for severe diffuse alveolar hemorrhage accompanied with untreated systemic lupus erythematosus in a child: a case report

AbstractBackground: Diffuse alveolar hemorrhage is considered a rare and acute complication of systemic lupus erythematosus, which occurs even if the patient had been treated with appropriate lupus therapy. Despite high mortality, a therapy for diffuse alveolar hemorrhage has not been established yet. Herein, we report a case of systemic lupus erythematosus in a young girl with diffuse alveolar hemorrhage who previously refused the standard therapy of lupus. She presented in an extremely serious condition; however, a combination therapy with plasmapheresis, steroid pulse therapy, and cyclophosphamide pulse therapy was successful in treating her.Case presentation: A 14-year-old girl with systemic lupus erythematosus, whose parents refused administration of the appropriate treatment was admitted to our hospital by ambulance at 7 months after diagnosis of SLE. She presented with fever, cough, hemosputum, dyspnea and sudden consciousness disorder. Using computed tomography and bronchoscopy, she was diagnosed ...