Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute respiratory distress, hemoptysis, and progressive dyspnea. Known history of SLE. Current symptoms include cough, pleuritic chest pain, and significant drop in hemoglobin levels. No evidence of active infection or fluid overload.
Clinical Examination Findings
Vitals: Tachycardic, tachypneic, hypoxic on room air. Pulmonary: Diffuse bilateral crackles/rales on auscultation. Skin: Possible malar rash or vasculitic lesions. Cardiovascular: Tachycardia, S1/S2 regular, no murmurs. Extremities: No peripheral edema.
Treatment Protocol
Immediate stabilization with supplemental oxygen/mechanical ventilation. High-dose intravenous pulse methylprednisolone (1g/day for 3 days). Initiate cyclophosphamide or rituximab as per SLE protocol. Consider plasmapheresis if refractory. Monitor serial CBC and chest imaging.