FATAL ALVEOLAR HEMORRHAGE IN A PATIENT WITH MIXED CONNECTIVE-TISSUE DISEASE PRESENTING POLYMYOSITIS FEATURES

A 22-year-old female with Raynaud's phenomenon, swollen hands and a hi gh titer of anti-RNP antibodies developed fever and myositis, Predniso lone (40 mg/day) was considered effective for myositis since circulati ng myogenic enzymes rapidly decreased. However, she suddenly developed respiratory distress with bilateral pulmonary infiltrates and bloody sputum, Under the diagnosis of alveolar hemorrhage (AH), intravenous m ethylprednisolone pulse therapy was given, but she died of respiratory failure. Autopsy findings demonstrated massive AH with hematoma forma tion, and myositis in the iliopsoas muscle, Depositions of immune comp lex and vasculitic lesions were not recognized in her lungs.