Abstract
Pulmonary haemorrhage (PH) is a rare but very serious complication of systemic lupus erythematosus (SLE) and the treatment is still controversial. Some authors showed the effectiveness of methylprednisolone pulse therapy for PH, although its effect was often transient. A 12-year-old Japanese girl with lupus nephritis and recurrent massive PH in SLE was treated with methylprednisolone pulse therapy. The effect on PH was transient and she needed three cycles within a month and side-effects developed. Pulse therapy with cyclophosphamide, synchronized with plasmaphaeresis, was tried. Thereafter she did not experience PH for 7 months, whereas lupus nephritis did not improve. Pulse cyclophosphamide would be effective for life threatening massive PH in SLE patients.
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Abbreviations
- PH :
-
pulmonary haemorrhage
- SLE :
-
systemic lupus erythematosus
References
Andonopoulos A (1991) Adult respiratory distress syndrome: An unrecognized premorten event in systemic lupus erythematosus. Br J Rheum 30: 346–348
Asano Y, Nagasawa K, Tuda Y, Nagano M, Kusaba K, Niho K (1987) An autopsy case of systemic lupus erythematosus complicated by pulmonary hermorrhage. Nippon Naika Gakkai Zasshi (in Japanese) 76: 436–440
Boumpas D, Barez S, Kippel J, Balow J (1990) Intermittent cyclophosphamide for the treatment of autoimmune thrombocytopenia in systemic lupus erythematosus. Ann Intern Med 112: 674–677
Boumpas D, Austin H, Vaughn E, Klippel J, Steinberg A, Yarboro C, Balow J (1992) Control trial of pulse methylpredonisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis. Lancet 340: 741–745
Churg A, Franklin W, Chan K, Kopp E, Carrington C (1980) Pulmonary hemorrhage and immune-complex deposition in the lung. Arch Pathol Lab Med 104: 388–391
Dau P, Callahan J, Parker R, Golbus J (1991) Immunologic effects of plasmapheresis synchronized with pulse cyclophosphamide in systemic lupus erythematosus. J Rheum 18: 270–276
Desnoyer R, Bernstein S, Cooper A, Kopelman R (1984) Pulmonary hemorrhage in systemic lupus erythematosus without evidence of an immunologic cause. Arch Intern Med 144: 1398–400
Euler H, Klein L, Gutschmidt H, Herlinger J (1982) Effect of early plasmapheresis and high dose cyclophosphamide therapy in Goodpasture's syndrome. In: Beyer J, Borberg H, Fuchs C, Nagel G (eds) Plasmapheresis in immunology and oncology. S Karger, Basel, pp 238–246
Klippel J (1987) NIH Conference: Lupus nephritis. Ann Intern Med 106: 79–94
Lehmann T, Sherry D, Weiner L, McCurdy D, Emery H, Maglavy D, Kovalesky A (1988) Intermitted intravenous cyclophosphamide therapy for lupus nephritis. J Pediatr 114: 1055–1060
Lewis E, Hunsicker L, Lan S, Pohde R, Lachin J (1992) A controlled trial of plasmapheresis therapy in severe lupus nephritis. N Engl J Med 326: 1373–1379
Meyers J, Katzenstein A (1986) Microangitis in lupus-induced pulmonary hermorrhage. Am J Clin Pathol 85: 552–556
Miller R, Salcedo J, Fink R, Murphy T, Magilavy D (1986) Pulmonary hermorrhage in pediatric patient with systemic lupus erythematosus. J Pediatr 108: 576–579
Morikawa Y, Danabara T, Kanemistu T, Inatome K, Yoshimine F, Kira S (1987) Fatal case of massive pulmonary hemorrhage after a 12-year history of systemic lupus erythematosus. Nippon Kyoubu Shikkan Gakkai Zassi (in Japanese) 25: 1236–1241
Ramirez R, Glasier C, Kirks D, Shackelford G, Locey M (1984) Pulmonary hermorrhage associated with systemic lupus erythematosus in children. Radiology 152: 409–412
Schroeder J, Euler H, Loeffler H (1991) Synchronization of plasmapheresis and pulse cyclphosphamide in severe systemic lupus erythematosus. Ann Inern Med 30: 346–348
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Fukuda, M., Kamiyama, Y., Kawahara, K. et al. The favourable effect of cyclophosphamide pulse therapy in the treatment of massive pulmonary haemorrhage in systemic lupus erythematosus. Eur J Pediatr 153, 167–170 (1994). https://doi.org/10.1007/BF01958977
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DOI: https://doi.org/10.1007/BF01958977