A Diagnostic Difficulty on ANA Negative/ Seronegative Systemic Lupus Erythematosus with Diffuse Alveolar Haemorrhage
For one month, a 45-year-old hypertensive lady suffered with a dry cough, dyspnea, and a crusted nonhealing lesion on her right ankle. Her anaemia, proteinuria, and thrombocytopenia were all getting worse. Pulmonary hypertension, a thrombus in the left internal jugular vein, and bilateral multilobar opacities were discovered on a CT pulmonary angiography. The right popliteal and left jugular veins have thrombus, according to a Doppler USG. Antiphospholipid antibodies were twice positive on serology, indicating a low C3, C4, negative ANA. Bronchoalveolar lavage confirmed diffuse alveolar haemorrhage (DAH). Lymphocytic vasculitis was discovered during an ulcer biopsy, which is an indication of immune complex deposition disorder. After meeting the clinical and immunological criteria of the Systemic Lupus International Collaborating Clinics, ANA negative SLE with DAH was discovered (SLICC).
Author (S) Details
Pratap Upadhya
Department of Pulmonary Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Gorimedu, India.
A. Ramya Priya
Department of Pulmonary Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Gorimedu, India.
M. Ravindra Chari
Department of Pulmonary Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Gorimedu, India.
Pampa Ch. Toi
Department of Pulmonary Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Gorimedu, India.
G. Vishnukanth
Department of Pulmonary Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Gorimedu, India.
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