Adult respiratory distress syndrome caused by acute systemic lupus erythematosus.

A 34-year-old man, previously diagnosed as having an idiopathic diffuse glomerulonephritis, developed an acute, fulminating pulmonary disease which fulfilled clinical, radiological and physiological criteria for ARDS. He also fulfilled criteria for the diagnosis of systemic lupus erythematosus. High-dose corticosteroid therapy, artificial respiration and hemodialysis were instituted and were followed by marked clinical, radiological and physiological improvement, returning to normal 15 days after admission. We discuss here the role of immune complexes in the pathogenesis of acute pulmonary vasculitis of lupus erythematosus and suggest a role of corticosteroid pulse therapy in treating ARDS of this etiology.