J Med Life Sci > Volume 14(1); 2017 > Article
Journal of Medicine and Life Science 2017;14(1):35-38.
DOI: https://doi.org/10.22730/jmls.2017.14.1.35    Published online December 18, 2018.
The combination therapy with extracorporeal membrane oxygenation, plasmapheresis and continuous renal replacement therapy for massive diffuse alveolar hemorrhage in a child with systemic lupus erythematosus
Su Wan Kim, Kyoung Hee Han
Correspondence:  Kyoung Hee Han,
Abstract
Diffuse alveolar hemorrhage (DAH) is a rare and life-threatening complication in children with systemic lupus erythematosus (SLE). Despite recent advances in medical therapy, DAH could drive into catastrophic respiratory failure and hemodynamic unstability. The authors present a case of a 9-year-old girl with lupus nephritis who had rapidly aggravating dyspnea and massive pulmonary hemorrhage. She was diagnosed as having DAH with acute respiratory distress syndrome and was successfully managed with combined treatment of venovenous extracorporeal membrane oxygenation (ECMO), plasmapheresis, and continuous renal replacement therapy (CRRT). We propose to introduce ECMO and plasmapheresisas early as possible as a rescue therapy in children with SLE complicated to DAH, who are irresponsive to conventional treatment.
Key Words: Systemic lupus erythematosus (SLE) ; Diffuse alveolar hemorrhage (DAH) ; Extracorporeal membrane oxygenation (ECMO) ; Plasmapheresis ; Continuous renal replacement therapy (CRRT) ; Child
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