Fulminant lupus pneumonitis with acute renal failure and RBC aplasia. Successful management with plasmapheresis and immunosuppression

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Abstract
Acute interstitial pneumonitis is a well-recognized, although rare, complication of systemic lupus erythematosus (SLE) that has been associated with a poor prognosis. Fulminant lupus pneumonitis, acute renal failure and RBC hypoplasia occurred in a 14 yr old girl. The patient''s condition was managed with large-volume plasmapheresis, dialysis and immunosuppressive therapy. Her respiratory, renal and hematologic changes all resolved. Response was maintained with cyclophosphamide and prednisolone therapy. Although serologic evidence of SLE persisted, clinically, the patient was well 4 yr after the initial appearance of SLE. There are several acute pulmonary manifestations of SLE; plasmapheresis may be useful in the management of some of these complications.