[A case of acute pulmonary hemorrhage and positive anti-glomerular basement membrane antibody in systemic lupus erythematosus].

A 58-year-old woman was admitted with cough, dyspnea on effort and diffuse micronodular and patchy shadows on her chest roentgenograms. Two weeks later, acute pulmonary hemorrhage developed with low levels of complement and positive immune complexes. She was diagnosed as having systemic lupus erythematosus (SLE) with positive anti-nuclear antibody, positive anti-DNA antibody, biologically false positive Wassermann reaction, auto-immune hemolytic anemia and photosensitive dermatoses. In addition, anti-glomerular basement membrane antibody (anti-GBM antibody) was positive in serum, but pulmonary hemorrhage was thought to be secondary to SLE, since the renal biopsy showed lupus nephritis. Cases of SLE with positive anti-GBM antibody are seldom confirmed. It was assumed that the basement membrane of the lung or kidney was damaged first by interstitial pneumonitis due to SLE or lupus nephritis, basement membranes antigens were exposed, with secondary production of anti-GBM antibody.