Massive pulmonary embolism and acute renal failure in a patient with systemic lupus erythematosus and secondary antiphospholipid syndrome: A case report

摘要

A 50 year old, previously healthy woman came to our attention with high fever, arthralgia and oliguria. Serological tests were positive for antinuclear antibodies, anti-double-stranded-DNA antibodies and cardiolipin antibodies. Renal histology indicated diffuse proliferative lupus nephritis. Three days after the hospitalisation, the patient developed massive pulmonary embolism and dialysis-dependent acute renal failure, for which she was dialysed. Heparin 1000 U/hour (7 days), methylprednisolone (1000 mg/day for 3 days) and cyclophosphamide (500 mg for one day) were administered. This therapy led to a dramatic improvement of renal and pulmonary functions and, consequently, treatment with hemodialysis could be stopped after 3 weeks. This case illustrates an uncommon manifestation of systemic lupus erythematosus associated with antiphospholipid syndrome.