Abstract
Systemic lupus erythematosus (SLE) is a complex disease with an etiological factor not completely understood, important morbidity and mortality, due both to autoimmune component and immunosuppressive treatment. Pseudotumor cerebri and diffuse alveolar hemorrhage are both secondary to an elevated autoimmune activity and low incidence; simultaneous is highly unlikely.
We present the case of a patient with SLE hospitalized for respiratory symptoms with a final diagnosis of a diffuse alveolar hemorrhage which favored a pseudotumor cerebri condition. Was treated with steroid pulses and plasmapheresis with adequate neurological and pulmonary response. A prompt diagnosis and treatment leads to better outcomes, especially with acute lung involvement, associated with a high mortality rate.
References
Stojan G, Petri M. Epidemiology of systemic lupus erythematosus: an update. Curr Opin Rheumatol. 2018;30(2):144-50.
Gergianaki I, Bertsias G. Systemic Lupus Erythematosus in Primary Care: an update and practical messages for the General Practitioner. Front Med (Lausanne). 2018 May 29;5:161..
Severiche Maury DM, Restrepo Escobar M, González Naranjo LA, Vanegas García AL, Muñoz Vahos CH, Vásquez Duque GM. Ciento quince pacientes con lupus eritematoso sistémico: características clínicas e inmunológicas. Rev Colomb Reumatol. 2014;21(4):183-92.
Fernández-Avila D, Bernal-Macías S, Rincón-Riaño D, Gutiérrez Dávila J, Rosselli D. Prevalence of systemic lupus erythe-matosus in Colombia: data from the national health registry 2012-2016. Lupus. 2019;28(10):1273-8.
Tektonidou MG, Lewandowski LB, Hu J, Dasgupta A, Ward MM. Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016. Ann Rheum Dis. 2017: 76(12):2009-2016.
Falasinnu T, Chaichian Y, Simard JF. Impact of sex on systemic lupus erythematosus-related causes of premature mortality in the United States. J Womens Health. 2017;26(11):1214-21.
Tselios K, Urowitz MB. Cardiovascular and pulmonary manifestations of systemic lupus erythematosus. Curr Rheumatol Rev. 2017;13(3):206-18.
Jafri K, Patterson SL, Lanata C. Central nervous system manifestations of systemic lupus erythematosus. Rheum Dis Clin. 2017;43(4):531-45.
West SG, Hanly JG. Lupus and the nervous system: clinical aspects, psychopathology, and imaging. Dubois' Lupus Erythematosus and Related Syndromes: Elsevier; 2019. p. 434-56.
Díaz-Cortés D, Correa-González N, Díaz MC, Gutiérrez JM, Fernández-Avila DG. Compromiso del sistema nervioso central en el lupus eritematoso sistémico. Rev Colomb Reumatol. 2015;22(1):16-30.
Raeeskarami S-R, Shahbaznejad L, Assari R, Aghighi Y Pseudotumor cerebri as the first manifestation of juvenile systemics erythematosus. Iran J Pediatr. 2016;26(5): e5176.
Hershko AY, Berkun Y, Mevorach D, Rubinow A, Naparstek Y, editors. Increased intracranial pressure related to systemic lupus erythematosus: a 26-year experience. Semin Arthritis Rheum. 2008;38(2):110-5.
Balbi GG, Matas SL, Len CA, Fraga MM, Sousa IO, Terreri MT. Pseudotumor cerebri in childhood and adolescence: data from a specialized service. Arq Neuro-Psiquiatr. 2018;76(11):751-5.
Ha Y-J, Lee YJ, Kang EH. Lung involvements in rheumatic diseases: Update on the epidemiology, pathogenesis, clinical features, and treatment. BioMed research international. 2018;2018: :6930297.
Cucuzza M, Marino S, Schiavone L, Smilari P, Filosco F, Barone P. Diffuse alveolar haemorrage as initial presentation of systemic lupus erythematosus: a case report. Lupus. 2018;27(3):507-10.
Andrade C, Mendonça T, Farinha F, Correia J, Marinho A, Almeida I, et al. Alveolar hemorrhage in systemic lupus erythematosus: a cohort review. Lupus. 2016;25(1):75-80.
Ednalino C, Yip J, Carsons SE. Systematic review of diffuse alveolar hemorrhage in systemic lupus erythematosus: focus on outcome and therapy. JCR: J Clin Rheumatol. 2015;21(6):305-10.
Kusunoki M, Umegaki T, Shoji T, Nishimoto K, Anada N, Ando A, et al. Severe progressive diffuse alveolar hemorrhage in a patient with systemic lupus erythematosus. Case Rep Crit Care. 2018 Jun 7;2018:9790459.
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