Diffuse Alveolar Hemorrhage as the initial Presentation of Systemic Lupus Erythematous Possibly Triggered by Rhogam Injection in a 24-year-old Pregnant Woman; a case report.

Abstract

Diffuse Alveolar Hemorrhage (DAH) is an uncommon and potentially life-threatening occurrence in systemic lupus erythematous (SLE), involving bleeding into the alveolar space caused by the disruption of the alveolar-capillary basement membrane. We present a 24-year-old Persian woman with a complaint of progressively worsening shortness of breath following the administration of intramuscular-Rhogam after 3 days. According to her worsening clinical condition, the pregnancy was terminated. She was admitted to intensive care unit and intubated. Simultaneously, she developed fungal and bacterial pneumonia tolerant to therapies. After several investigations, the patient was finally diagnosed with SLE along with diffuse alveolar hemorrhage, as the first presentation of the disease. This is the first case of a pregnant woman experiencing diffuse alveolar hemorrhage as a Lupus flare following Rhogam injection. Clinicians should be aware of the mimicry nature of lupus, and the importance of immune reactions in these patients.