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Lupus pneumonitis: management with high-flow oxygen therapy and prone position. Case report and review

Flores Ramírez, Raymundo , Argüello Bolaños, Jardiel , González Perales, Kenia , Gallardo Soberanis, José Roberto , Medina Viramontes, Mónica Elizabeth , Pozos Cortés, Karen Pamela , González Toribio, Raúl Arturo , López Castro, Julio Hiram , Deloya Tomas, Ernesto , Pérez Nieto, Orlando Rubén





2019, Number 2

2019; 78 (2)






ABSTRACT

Lupus pneumonitis is an unusual manifestation of systemic lupus erythematosus. It’s presented initially in 1-12% of the cases, manifested by acute respiratory distress syndrome (ARDS) and an unfavorable evolution with a mortality reported from 50% to 90%. There are strategies for the management of patients with severe ARDS, such as the prone position in mechanically ventilated patients associated with alveolar protection measures. Recently, the usefulness of the prone position in patients with high-flow oxygen therapy has been proposed as a therapeutic option. We present the case of a 19-year-old woman with lupus pneumonitis as the debut of systemic lupus erythematosus and respiratory failure that was successfully diagnosed and managed with high-flow oxygen therapy and prone position, combined with corticosteroid treatment, avoiding advanced management of the airway and mechanical ventilation.

KEYWORDS

Systemic lupus erythematosus, lupus pneumonitis, prone position, high flow oxygen therapy, acute respiratory distress syndrome.

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2019, Number 2

2019; 78 (2)