P. Upadhya, A. Priya, M. Chari, P. Toi, G. Vishnukanth
{"title":"A Diagnostic Difficulty on ANA Negative/ Seronegative Systemic Lupus Erythematosus with Diffuse Alveolar Haemorrhage","authors":"P. Upadhya, A. Priya, M. Chari, P. Toi, G. Vishnukanth","doi":"10.9734/bpi/nfmmr/v8/3807f","DOIUrl":null,"url":null,"abstract":"A 45-year-old hypertensive woman had a dry cough, dyspnea, and a crusted nonhealing ulcer on her right ankle for one month. She was suffering from worsening anaemia, proteinuria, and thrombocytopenia. A CT pulmonary angiogram revealed pulmonary hypertension, a thrombus in the left internal jugular vein, and bilateral multilobar opacities. A Doppler USG revealed thrombus in the right popliteal and left jugular veins. Serology revealed a low C3, C4, negative ANA with antiphospholipid antibodies that were twice positive. Diffuse alveolar bleeding was confirmed by bronchoalveolar lavage (DAH). An ulcer biopsy revealed lymphocytic vasculitis, which is a sign of immune complex deposition disorder.ANA negative SLE with DAH was identified after meeting the clinical and immunological criteria of the Systemic Lupus International Collaborating Clinics (SLICC).","PeriodicalId":138368,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 8","volume":"37 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"New Frontiers in Medicine and Medical Research Vol. 8","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.9734/bpi/nfmmr/v8/3807f","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
A 45-year-old hypertensive woman had a dry cough, dyspnea, and a crusted nonhealing ulcer on her right ankle for one month. She was suffering from worsening anaemia, proteinuria, and thrombocytopenia. A CT pulmonary angiogram revealed pulmonary hypertension, a thrombus in the left internal jugular vein, and bilateral multilobar opacities. A Doppler USG revealed thrombus in the right popliteal and left jugular veins. Serology revealed a low C3, C4, negative ANA with antiphospholipid antibodies that were twice positive. Diffuse alveolar bleeding was confirmed by bronchoalveolar lavage (DAH). An ulcer biopsy revealed lymphocytic vasculitis, which is a sign of immune complex deposition disorder.ANA negative SLE with DAH was identified after meeting the clinical and immunological criteria of the Systemic Lupus International Collaborating Clinics (SLICC).