Diffuse alveolar hemorrhage

Case contributed by Liz Silverstone
Diagnosis almost certain

Presentation

Acute dyspnea.

Patient Data

Age: 25 years
Gender: Female
ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial lung
window
This study is a stack
Axial lung window
- expiratory phase
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Info

Widespread ground-glass opacity with relative sparing of the cortex.

Clearly visible interventricular septum indicates anemia.

No gas-trapping on expiration.

DIAGNOSTIC SUMMARY: Native renal biopsy: Diffuse proliferative glomerulonephritis with crescent formation, features of WHO Type IV lupus nephritis.

Hb 57*L 2 weeks prior 95*L (normal 115-165 g/L)

ANA Titer >1/640*

ENA Screen Positive*

Smith Str Positive*

RNP/SM Str Positive*

Scl-70 Positive*

Ribo P Wk Positive*

Case Discussion

Typical features of acute diffuse alveolar hemorrhage and anemia due to SLE.

The lungs cleared within two weeks.

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