A Case of Anti-Glomerular Basement Membrane Antibody-Positive Systemic Lupus Erythematosus with Pulmonary Hemorrhage Successfully Treated at an Early Stage of the Disease
| Autor: | Shuichi Tsuruoka, Shizuka Yui, Akira Shimizu, Takehisa Yamada, Tetsuya Kashiwagi, Fumiaki Itagaki, Yoko Endo, Seiichiro Higo, Koji Mugishima, Yukie Yoshida |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Lung Diseases medicine.medical_specialty Time Factors Biopsy Prednisolone 030232 urology & nephrology Hemorrhage 030204 cardiovascular system & hematology urologic and male genital diseases Kidney Pericardial effusion Gastroenterology Methylprednisolone Serology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Glomerular Basement Membrane medicine Humans Lupus Erythematosus Systemic Hypoalbuminemia Autoantibodies Creatinine Proteinuria Leukopenia medicine.diagnostic_test Plasma Exchange business.industry General Medicine medicine.disease Combined Modality Therapy Early Diagnosis Treatment Outcome chemistry Pulse Therapy Drug Female Pulmonary hemorrhage Renal biopsy medicine.symptom business Tomography X-Ray Computed Biomarkers |
| Zdroj: | Journal of Nippon Medical School = Nippon Ika Daigaku zasshi. 85(2) |
| ISSN: | 1347-3409 |
| Popis: | We report here a case of systemic lupus erythematosus (SLE) with pulmonary hemorrhage and anti-glomerular basement membrane (anti-GBM) antibodies. A 42-year-old woman was admitted to our hospital with complaints of exanthema, arthralgia, shortness of breath, and hemoptysis. Plain chest computed tomography (CT) scan revealed pericardial effusion, bilateral pleural effusions, and pulmonary hemorrhage. Laboratory findings on admission revealed proteinuria, microscopic hematuria, anemia, leukopenia, hypoalbuminemia, hypocomplementemia, and slightly elevated levels of serum creatinine. Serological tests revealed elevated titers of serum anti-GBM antibodies, proteinase 3-antineutrophil cytoplasmic antibodies (PR3-ANCA), and anti-double stranded deoxyribonucleic acid (dsDNA)-immunoglobulin G (IgG) antibodies. Early treatment with steroid pulse therapy combined with plasma exchange resolved the patient's pulmonary hemorrhage and renal dysfunction. Renal biopsy carried out after the treatment revealed a recovery phase of acute tubular injury with minor glomerular abnormalities without linear IgG deposition along the GBMs. For a good prognosis, it is necessary to start treatment immediately in patients with anti-GBM antibody-positive SLE associated with pulmonary hemorrhage. |
| Databáze: | OpenAIRE |
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