Objective: To determine the clinical features of systemic lupus erythematosus (SLE) patients with diffuse alveolar hemorrhage (DAH).
Methods: The medical records of seventeen SLE patients with DAH were reviewed.
Results: Hypoxemia (100%), dyspnea (88%), cough (88%) and fever (82%) were the most common symptoms instead of hemoptysis (71%). The most common extrapulmonary presentation was renal involvement (94%). About 60% patients were complicated with lung infection. The mean drop in hemoglobin was (32 +/- 11.3) g/L. Mean SLEDAI was (17 +/- 10). All received high-dose steroids and most also were given cyclophosphamide. Ratio of mechanical ventilation in non-survivors was higher than that of survivors (P < 0.05).
Conclusions: DAH is a rare and catastrophic event in SLE. DAH can occur in any course, which suggests active SLE, and frequently complicated with lupus nephritis. Some patients may have no hemoptysis.