A Fatal Case of Massive Pulmonary Hemorrhage After a 20-Year History of Systemic Lupus Erythematosus

Abstract

A 36-year-old female was hospitalized due to hemoptysis and severe respiratory failure with sudden onset. Twenty years prior to admission, systemic lupus erythematosus (SLE) had been diagnosed. Chest X-ray film revealed extensive infiltrates in both lung fields. She was treated with “pulse” methylprednisolone therapy because it was judged that this hemorrhage was complicated with SLE. After a transient remission for a few weeks, she died of recurrent intrapulmonary hemorrhage on the 30th hospital day.
Autopsy findings showed diffuse hemorrhage in the alveolar spaces without alveolitis. Immunofluorescence studies revealed granular deposition of IgG on glomerular capillary of the basement membranes in kidneys, but no immunoglobulin deposition in lungs.