Wan S A, Teh C L, Jobli A T
1 Department of Medicine, Sarawak General Hospital, Sarawak, Malaysia.
2 Radiology Department, University Malaysia Sarawak, Sarawak, Malaysia.
Lupus. 2016 Nov;25(13):1485-1490. doi: 10.1177/0961203316646461. Epub 2016 Jul 11.
Objective The aim of this study was to examine the clinical features, treatment and outcome of systemic lupus erythematosus (SLE) patients in our centre who presented with lupus pneumonitis as the initial manifestation. Methods We performed a retrospective review of all patients who presented with lupus pneumonitis during the initial SLE manifestation from March 2006 to March 2015. Results There were a total of five patients in our study who presented with fever and cough as the main clinical features. All patients had pulmonary infiltrates on chest radiographs. High-resolution computed tomography, which was performed in two patients, showed ground glass opacities with patchy consolidations bilaterally. All patients received high-dose steroids, 80% received intravenous cyclophosphamide and 60% received intravenous immunoglobulin. Two patients died from severe lupus pneumonitis within 2 weeks of admission despite treatment with ventilation, steroids, cyclophosphamide and intravenous immunoglobulin. Conclusions Acute lupus pneumonitis is an uncommon presentation of SLE. Mortality in this case series is 40%.
目的 本研究旨在探讨我院以狼疮性肺炎为首发表现的系统性红斑狼疮（SLE）患者的临床特征、治疗及预后。方法 我们对2006年3月至2015年3月期间以狼疮性肺炎为SLE首发表现的所有患者进行了回顾性研究。结果 我们的研究共有5例患者，主要临床特征为发热和咳嗽。所有患者胸部X线片均有肺部浸润。2例患者进行了高分辨率计算机断层扫描，显示双侧磨玻璃样阴影伴斑片状实变。所有患者均接受了大剂量激素治疗，80%接受了静脉环磷酰胺治疗，60%接受了静脉注射免疫球蛋白治疗。尽管接受了通气、激素、环磷酰胺和静脉注射免疫球蛋白治疗，仍有2例患者在入院后2周内因严重狼疮性肺炎死亡。结论 急性狼疮性肺炎是SLE的一种罕见表现。本病例系列的死亡率为40%。
