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KMID : 1161920170140010035
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Journal of Medicine and Life Science
2017 Volume.14 No. 1 p.35 ~ p.38
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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
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Kim Su-Wan
Han Kyoung-Hee
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Abstract
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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.
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KEYWORD
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Systemic lupus erythematosus (SLE), Diffuse alveolar hemorrhage (DAH), Extracorporeal membrane oxygenation (ECMO), Plasmapheresis, Continuous renal replacement therapy (CRRT), Child
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