Systemic lupus erythematosus (SLE) pneumonitis mimicking swine influenza pneumonia during the swine influenza (H1N1) pandemic

Cunha, Burke A.; Syed, Uzma; Mickail, Nardeen

doi:10.1016/j.hrtlng.2010.07.008

Cited by 5 publications

(1 citation statement)

References 21 publications

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“…Infections in differential diagnosis include bacteria, fungi, and viruses. There are reported cases of ALP mimicking bacterial pneumonia, 11 viral pneumonia (H1N1), 12 and pulmonary tuberculosis. 13 We excluded infective pneumonia including tuberculosis by negative sputum and blood cultures, EZN staining, procalcitonin, real-time polymerase chain reaction (RT-PCR) and antibody testing for SARS-CoV-2, and lack of response to antibiotics.…”

Section: Discussionmentioning

confidence: 99%

20-Year-old female with fever, cough, and dyspnea: Acute lupus pneumonitis during the pandemic of coronavirus disease 2019 (COVID-19)

Tuğsal

İzdeş

Küçükşahin

2021

Lupus

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Acute lupus pneumonitis (ALP) is a rare first-presenting manifestation of systemic lupus erythematosus (SLE). The characteristic symptoms are rapid onset of fever, cough (sometimes with hemoptysis), and dyspnea. ALP may progress to acute respiratory distress syndrome (ARDS), and it is a potentially fatal disease unless treated. Coronavirus disease 19 (COVID-19) has overlaps with ALP in terms of clinical presentation, and laboratory and radiological findings. This report describes a case of a young female patient presenting with ARDS during the pandemic of COVID-19. She had pancytopenia, elevated CRP, ferritin, and liver indices resembling macrophage activation syndrome. She also had hepatosplenomegaly, a small spleen infarct, adenopathy, minimal pleural, and pericardial effusion. After excluding COVID-19 by PCR and antibody tests, and other infections by cultures, with the help of antinuclear antibody and anti–double-stranded DNA, SLE and ALP were diagnosed, and she was treated with high-dose steroid and intravenous immunoglobulin. In conclusion, if patients presenting with pneumonia or ARDS have one or more of the findings of arthritis, serositis, rash, oral/nasopharyngeal ulcerations, cytopenias, and renal or neurologic disorder, SLE and ALP should be considered in differential diagnoses. Because of the high mortality rate of ALP reaching up to 50%, early diagnosis and immunosuppressive therapy are of vital importance.

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Section: Discussionmentioning

confidence: 99%