Korean J Crit Care Med.  2016 Nov;31(4):364-368. 10.4266/kjccm.2016.00451.

Successful Use of Extracorporeal Membrane Oxygenation in Diffuse Alveolar Hemorrhage Secondary to Systemic Lupus Erythematosus

• Choi GH
• Kang MI

• KMID: 2371193
• DOI: http://doi.org/10.4266/kjccm.2016.00451

Abstract

Diffuse alveolar hemorrhage (DAH) is an uncommon complication in patients with systemic lupus erythematosus (SLE), and mortality remains high. In recent years, cases of DAH due to SLE treated with extracorporeal membrane oxygenation (ECMO) have rarely been reported. The authors present a case of a 43-year-old woman with SLE who had rapidly aggravating dyspnea and hemoptysis. She was diagnosed as having DAH with refractory respiratory failure and was successfully managed with veno-venous ECMO. We propose ECMO as a useful salvage therapy in patients with alveolar hemorrhage secondary to SLE who are failing conventional ventilatory support.

Keyword

extracorporeal membrane oxygenation; lupus erythematosus, systemic; respiratory distress syndrome, adult

MeSH Terms

Adult
Dyspnea
Extracorporeal Membrane Oxygenation*
Female
Hemoptysis
Hemorrhage*
Humans
Lupus Erythematosus, Systemic*
Mortality
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Salvage Therapy

Figure

• 

  Fig. 1. (A) Chest radiography at the time of hospitalization. Initial chest radiography shows multifocal patchy consolidations in both lungs. (B) Initial chest computed tomography. Chest computed tomography scan shows bilateral multifocal patchy consolidations and ground glass appearance with mild interlobular septal thickening and air-bronchograms in both lungs.

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  Fig. 2. Chest radiography after the initiation of extracorporeal membrane oxygenation (ECMO). Chest radiography immediately after the initiation of ECMO shows more aggravated bilateral alveolar infiltrates than seen on prior imaging studies.

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  Fig. 3. Chest radiography prior to discharge. Chest radiography was performed prior to discharge and shows improvement in both lungs.

Reference

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