Abstract
We describe three females with systemic lupus erythematosus (SLE) who developed alveolar hemorrhage. Although they did not show any episodes of bleeding from the lung at first, bronchoscopy was performed in two of the three cases. The diagnosis of alveolar hemorrhage was made based upon the bloody bronchoalveolar lavage fluid and the transbronchial lung biopsy. Electron-dense deposits were identified in the alveolar basement membrane. These two patients responded well to the pulse-steroid therapy. This rare complication of SLE usually develops insidiously but rapidly, and its prognosis is extraordinarily poor. Only two autopsy cases have been reported in Japan. We emphasize the importance of bronchoscopy for the early diagnosis, and intensive respiratory care for the treatment of alveolar hemorrhage in SLE patients.
