Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

Alveolar Hemorrhage: Distinct Clinical Profile in Adult and Juvenile Systemic Lupus Erythematosus Patients.

Araujo1,  Daniel B., Neto1,  Eduardo F. Borba, Silva1,  Clovis A., Campos1,  Lucia M.A., Pereira2,  Rosa M.R., Bonfa1,  Eloisa, Shinjo1,  Samuel K.

Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
Disciplina de Reumatologia da FMUSP, Sao Paulo, Brazil


Alveolar hemorrhage (AH) is a rare and severe manifestation of systemic lupus erythematosus (SLE). Therefore, the aim of this study was to compare characteristics of AH in juvenile (JSLE) and adult SLE (ASLE) patients.


from January 1990 to January 2010, 28 out of 1785 SLE patients (13 JSLE and 15 ASLE) had AH in our tertiary hospital.


JSLE and ASLE had comparable disease duration (2.6 ± 3.0 vs. 5.6 ± 7.0 years, p=0.151) with the mean age at AH diagnosis of 15.3 ± 2.7 and 28.7 ± 10.3 yrs for JSLE and ASLE, respectively. The frequency of AH events was significantly higher in JSLE [4.94% (13/263)] compared to ASLE patients [0.99% (15/1522)], p<0.001 and it was diagnosed at SLE onset in two (15.4%) JSLE and six (40.0%) ASLE patients p=0.221). Before AH event, the JSLE patients were using a higher mean dose of prednisone (>0.5mg/kg/day) when compared to ASLE 54%vs. 15%, p=0.042). Macrophage activation syndrome with macrophage hemophagocytosis was only observed in JSLE compared to ASLE patients with AH diagnosis (23%vs. 0%, p=0.087). Regarding outcomes, frequencies of death were significantly higher in JSLE than ASLE patients (69%vs. 13%, p=0.006), with a trend of higher frequency of mechanical ventilation use (85%vs. 47%, p=0.055). In spite of that, the mean drop of hemoglobin was significantly lower in JSLE patients (2.9 ± 0.9 vs. 5.5 ± 2.9 g/dL, p=0.006). All other demographical, clinical and laboratory features were alike in both groups (p>0.050).


This study revealed that AH is more prevalent in juvenile lupus with a worse outcome compared to adult SLE patients.

To cite this abstract, please use the following information:
Araujo, Daniel B., Neto, Eduardo F. Borba, Silva, Clovis A., Campos, Lucia M.A., Pereira, Rosa M.R., Bonfa, Eloisa, et al; Alveolar Hemorrhage: Distinct Clinical Profile in Adult and Juvenile Systemic Lupus Erythematosus Patients. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2046

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