Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Fatal Acute Lupus Pneumonitis Defined by Necropsy

병리조직학적으로 확인된 급성루프스성 폐렴 1예

  • Yoon, Ki-Heon (Department of Internal Medicine, College of Medicine, Kyung Hee University) ;
  • Yoo, Jee-Hong (Department of Internal Medicine, College of Medicine, Kyung Hee University) ;
  • Kang, Hong-Mo (Department of Internal Medicine, College of Medicine, Kyung Hee University)
  • 윤기헌 (경희대학교 의과대학 내과학교실) ;
  • 유지홍 (경희대학교 의과대학 내과학교실) ;
  • 강홍모 (경희대학교 의과대학 내과학교실)
  • Published : 1992.02.29
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Abstract

A 16 years old girl with systemic lupus erythematosus had a high fever for 20 days. Skin and renal biopsy showed diffuse granular deposits (IgG, IgM, $C_3$, $C_{1q}$ at dermo-epideral junction and IgG, IgA, IgM, $C_3$, $C_{1q}$, fibrinogen in the renal mesangium and segmentally along the capillary walls) which were compatable with systemic lupus erythematosus. The chest X-ray revealed patchy mottled densities in whole lung field when she complained more dyspnea at 9th hospital days. Even with the parenteral administration of broad-spectrum antibiotics, the symptoms of high fever, cough, tachydyspnea and hypoxia were continued. At 24th hospital day, the clinical course was rapidly deteriorated after sudden loss of consciousness with focal seizure which suggested CNS involvement during hydrocortisone administration for 10 days. She died of respiratory failure despite the mechanical ventilatory support with PEEP. The limited necropsy showed interstitial pneumonia, alveolar hemorrhage and occlusive necrotizing vasculitis of acute lupus pneumonitis.

저자들은 전신성홍반성낭창에서 신장염에 이어 급성 폐렴이 발생하여 이의 악화로 사망한 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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