A case of fetal acute lupus pneumonitis defined by necropsy.

Yoon, Ki Heon; Yoo, Jee Hong; Kang, Hong Mo

doi:1992.39.1.89

Tuberc Respir Dis > Volume 39(1); 1992 > Article

Original Article

Tuberculosis and Respiratory Diseases 1992;39(1):89-94.
DOI: https://doi.org/10.4046/trd.1992.39.1.89 Published online February 1, 1992.

A case of fetal acute lupus pneumonitis defined by necropsy.

Ki Heon Yoon, Jee Hong Yoo, Hong Mo Kang

Department of Internal Medicine, College of Medicine, Kyunghee University, Seoul, Korea

Abstract

A 16 years old girl with systemic lupus erythematosus had a high fever for 20 days. Skin and renal biopsy showed diffuse granular deposits (IgG, IgM, C₃, C_1q at dermo-epideral junction and IgG, IgA, IgM, C₃, C_1q, fibrinogen in the renal mesangium and segmentally along the capillary walls) which were compatable wi th systemic lupus erythematosus. The chest X-ray revealed patchy mottled densities in whole lung field when she complained more dyspnea at 9th hospital days. Even with the parenteral administration of broad-spectrum antibiotics, the symptoms of high fever, cough, tachydyspnea and hypoxia were continued. At 24th hospital day, the clinical course was rapidly deteriorated after sudden loss of consciousness with focal seizure which suggested CNS invo lvement during hydrocortisone administration for 10 days. She died of respiratory failure despite the mechanical ventilatory support with PEEP The limited necropsy showed interstitial pneumonia. alveolar hemorrhage and occlusive necrotizing vasculitis of acute lupus pneumonitis.

Key Words: Sytemic lupus erythematosus, Lupus pneumonitis, Necropsy, Alveolar hemorrhage, Necrotizi ng vasculitis