Diffuse alveolar haemorrhage as the initial presentation of systemic lupus erythematosus possibly triggered by Rhogam injection in a 24-year-old pregnant woman: A case report.

Abstract

Diffuse alveolar haemorrhage (DAH) is an uncommon and potentially life-threatening occurrence in systemic lupus erythematosus, 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 the intensive care unit and intubated. Simultaneously, she developed fungal and bacterial pneumonia tolerant to therapies. After several investigations, the patient was finally diagnosed with systemic lupus erythematosus along with DAH, as the first presentation of the disease. This is the first case of a pregnant woman experiencing DAH 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.