Marte Furment Marlene, Sharma Suyansh, Pabolu Sangeetha
Internal Medicine Department, Saint Peter's University Hospital, Rutgers Robert Wood Johnson Medical School Program, New Brunswick, NJ, USA.
Rheumatology Department, Saint Peter's University Hospital, Rutgers Robert Wood Johnson Medical School Program, New Brunswick, NJ, USA.
Case Rep Rheumatol. 2020 Dec 21;2020:8839410. doi: 10.1155/2020/8839410. eCollection 2020.
This is a case of new-onset systemic lupus erythematosus (SLE) manifesting as acute pneumonitis during pregnancy. No prior reports have documented pneumonitis as the presenting manifestation of SLE in pregnant women. . A 23-year-old pregnant female presented with high-grade fever, cough, arthralgias, and respiratory failure. Infectious workup was negative. She was positive for ANA, anti-dsDNA, anti-SSA, hypocomplementemia, and pulmonary infiltrates, supporting the diagnosis of SLE and pneumonitis. The patient received methylprednisolone achieving adequate clinical and serological response.
When SLE patients present with fever, cough, and respiratory failure, pulmonary infiltrates should raise the suspicion of pneumonitis in the absence of infection and hemorrhage. Even though acute lupus pneumonitis (ALP) is rare and seen only in 2% of SLE patients, a high index of suspicion aids in prompt diagnosis of this life-threatening condition. Also, positive anti-SSA antibodies may be associated with lupus pneumonitis.
这是一例新发系统性红斑狼疮（SLE）在孕期表现为急性肺炎的病例。此前尚无报告记载肺炎为孕妇SLE的首发表现。一名23岁的孕妇出现高热、咳嗽、关节痛和呼吸衰竭。感染相关检查结果为阴性。她抗核抗体（ANA）、抗双链DNA（anti-dsDNA）、抗干燥综合征A抗原（anti-SSA）呈阳性，补体水平降低，并有肺部浸润，支持SLE和肺炎的诊断。患者接受甲泼尼龙治疗后获得了充分的临床和血清学反应。
当SLE患者出现发热、咳嗽和呼吸衰竭，且肺部有浸润但无感染和出血时，应怀疑肺炎。尽管急性狼疮性肺炎（ALP）罕见，仅见于2%的SLE患者，但高度怀疑有助于及时诊断这种危及生命的疾病。此外，抗SSA抗体阳性可能与狼疮性肺炎有关。
