Predictors of Mortality in Pulmonary Haemorrhage during SLE: A Single Centre Study Over Eleven Years

BACKGROUND: Pulmonary haemorrhage (PH) is a serious complication during Systemic Lupus Erythematosus (SLE). AIM: The aim was to present data on 12 patients of SLE with classic symptoms and signs of PH admitted throughout eleven years. METHODS: This retrospective study was carried out at King Abdul Aziz Specialist hospital in Taif-a tertiary care hospital in the western region of Saudi Arabia. The data was analysed from the case files of SLE patients who had episodes of PH throughout 11 years (January 2007 to December 2017). RESULTS: Twelve patients (10 females and 2 males) were found to have diffuse pulmonary haemorrhage during their SLE in the study period. Of 12 patients with confirmed pulmonary haemorrhage (hemoptysis, hypoxemia, new infiltrates on chest radiography, fall in haemoglobin and hemorrhagic returns of bronchoalveolar lavage with hemosiderin-laden macrophages) 4 patients had PH as the first presentation of SLE and 8 patients developed this complication during the disease. All patients presented with shortness of breath and hemoptysis. The most common extra-pulmonary involvement in the study cohort was renal (83%), which ranged from clinical nephritis, nephrotic syndrome to acute renal failure. All patients were managed in intensive care of the hospital, and of 12 patients, 9 (75%) required mechanical ventilation. All patients were uniformly treated with pulse Methylprednisolone; 9 received Cyclophosphamide, 6 received IVIG, and 4 received Plasmapheresis. Only 3 patients (25%) survived despite maximum possible support during their mean hospital stay of 18 ± 5 days. CONCLUSION: The requirement of mechanical ventilation and the association of renal and neuropsychiatric complications predicted mortality in patients with pulmonary haemorrhage

Idiopathic colonic calcification: a case report [Idiopathische Kalkeinlagerung im Colon: ein Fallbericht]

[english] We describe diffuse colonic calcification detected on CT scan of the abdomen in a young female patient who presented to our clinic with vague intermittent abdominal pain of four weeks duration. Her investigative profile was normal and her colonoscopy did not reveal any mucosal changes. Colonic calcification has been known to occur mostly as a result of ischemic phenomenon but the index case had no such features or any other predisposing factor. The patient is currently symptom-free and is following our clinic for the last 8 months. After the review of literature and thorough investigations her colonic calcification remains unexplained.<br>[german] Wir berichten über eine diffuse Kalkeinlagerung im Colon einer jungen Frau, die beim CT des Abdomens entdeckt wurde. Die Patientin wurde wegen unklarer, wiederholt auftretender Bauchschmerzen von 4 Wochen Dauer in unserer Klinik vorgestellt. Die allgemeine Untersuchung ergab einen regelrechten Befund, bei der allgemeinen Colonoskopie wurden keine Mucosa-Schäden gefunden. Verkalkungen im Colon wurden bisher als Folge von Ischämien angenommen, aber im vorliegenden Fall gab es keine derartigen Hinweise oder andere prädisponierende Faktoren. Die Patientin ist derzeit frei von Beschwerden und wird von unserer Klinik seit 8 Monaten überwacht. Nach Durchsicht der Literatur und gründlicher Untersuchung bleibt die Ursache der Verkalkung im Colon nicht erklärbar