系统性红斑狼疮并弥漫性肺泡出血的临床研究(附2例报道)

目的提高对系统性红斑狼疮(SLE)并弥漫性肺泡出血(DAH)的认识。方法报道2例SLE并DAH的临床资料,并复习相关文献。结果通过分析病例,总结SLE并DAH的临床特点、发病机制、诊断标准、治疗手段和预后。结论DAH为SLE少见而致命的并发症,发热、咯血、呼吸困难、血红蛋白下降等临床表现无特异性。影像学显示双肺弥漫性浸润影。血性支气管肺泡灌洗液内见含铁血黄素巨噬细胞。肺组织学呈弥漫性肺泡出血。早期足量激素和免疫抑制剂治疗可改善其预后。

A Report of 2 Cases of Systemic Lupus Erythematosus Complicated with Diffuse Alveolar Hemorrhage and Literature Review

Objective To improve the understanding of systemic lupus erythematosus(SLE)complicated with diffuse alveolar hemorrhage(DAH).Methods 2 cases of SLE complicated with DAH were reported and the related literatures were reviewed.Results Through analyzing the cases,the clinical feature,pathophysiology,diagnosis,treatment and prognosis of SLE complicated with DAH were summarized.Conclusion DAH is a rare and fatal complication of patients with SLE.The clinical presentations,such as fever,hemoptysis,dyspnea,fall in haemoglobin,were unspecific.Chest radiographys showed diffuse alveolar infiltration in both lung.Bronchoalveolar lavage fluid denoted hemorrhage and macrophage that swallawed hemosiderin can be found in it.Lung histology displayed diffuse alveolar hemorrhage.The early high sufficient dose corticsteroid and immunosuppressive therapy can improve the survival.