Massive pulmonary thromboembolism in a patient with systemic lupus erythematosus: A case report

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A 16-year-old female patient applied to our emergency department with a one day history of increasing dyspnea, left sided thoracic pain and syncope. She also had systemic lupus erythematosus and was receiving methylprednisolone and hydroxychloroquine for treatment. Arterial blood gas analysis in the room air were: pH: 7.49, pO2: 59 mmHg, pCO2: 30 mmHg, HCO3: 21 mmol/L, SaO2%: 89, Alveolo-arterial oxygen (A-a O2) gradient: 53. Echocardiography examination revealed that mean pulmonary artery pressure was 45 mmHg and right heart chambers were dilated. The spiral thoracic computed tomography showed thrombus in the left main pulmonary artery, in the right basal truncus artery and in its segmental branches. We administered thrombolytic therapy to the patient with the indication of massive pulmonary thromboembolism. After the thrombolytic therapy, the general state of the patient improved, tachypnea and dyspnea regressed and arterial blood pressure increased.

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Systemic lupus erythematosus , massive pulmonary thromboembolism , thrombolytic therapy

Cumhuriyet Medical Journal

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Cumhuriyet Medical Journal