Chen Mei-Chuan, Wu Yueh-Lin, Lee Kai-Ling, Lai Kevin S, Chung Chi-Li
Division of Pulmonary Medicine, Department of Internal Medicine Taipei Medical University Hospital Taipei Taiwan.
Division of Nephrology Medicine, Department of Internal Medicine Taipei Medical University Hospital Taipei Taiwan.
Respirol Case Rep. 2017 Oct 27;6(1):e00280. doi: 10.1002/rcr2.280. eCollection 2018 Jan.
Lupus pneumonitis carries high mortality and is a rare manifestation of systemic lupus erythematosus (SLE). However, it is difficult to diagnose and is often mistaken as pneumonia, alveolar haemorrhage, or organizing pneumonia. Previous studies demonstrated that serum anti-Ro antibodies are elevated more frequently in SLE patients with pneumonitis than in those without. We report a 21-year-old female who was newly diagnosed as having SLE with nephritis and who suddenly developed right lung opacity and rapidly progressed to severe hypoxaemia despite the use of broad-spectrum antibiotics. The serum titre of anti-Ro antibody was greater than 240 U/mL. She underwent lung biopsy and lupus pneumonitis was confirmed by the pathological findings. Subsequently, she showed a favourable response to plasma exchange, steroid pulse therapy, and mycophenolate mofetil (MMF) treatment. For SLE patients with pulmonary infiltrates, high degree of clinical suspicion of lupus pneumonitis is required and measurement of serum anti-Ro antibody may help to make the diagnosis.
狼疮性肺炎死亡率高，是系统性红斑狼疮（SLE）的一种罕见表现。然而，其诊断困难，常被误诊为肺炎、肺泡出血或机化性肺炎。既往研究表明，与无肺炎的SLE患者相比，患有肺炎的SLE患者血清抗Ro抗体升高更为频繁。我们报告一名21岁女性，新诊断为SLE合并肾炎，尽管使用了广谱抗生素，仍突然出现右肺混浊并迅速发展为严重低氧血症。抗Ro抗体血清滴度大于240 U/mL。她接受了肺活检，病理结果证实为狼疮性肺炎。随后，她对血浆置换、激素冲击疗法和霉酚酸酯（MMF）治疗反应良好。对于有肺部浸润的SLE患者，需要高度怀疑狼疮性肺炎，检测血清抗Ro抗体可能有助于诊断。
