{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T23:09:05Z","timestamp":1723158545833},"reference-count":0,"publisher":"Ordem dos Medicos","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>Systemic lupus erythematosus is a heterogeneous and unpredictable autoimmune disease which can be complicated to approach\u00a0and treat. Hemophagocytic lymphohistiocytosis and diffuse alveolar hemorrhage are rare disease complications. The authors describe\u00a0a clinical case of a 32-year-old woman with lupus and fever of unknown origin. From the investigations performed, the myelogram\u00a0revealed hemophagocytosis and Leishmania parasites, therefore liposomal amphotericin B was then started. In addition to directed\u00a0therapy, she maintained fever that evolved with diffuse alveolar hemorrhage. The myelogram was repeated and showed that she still\u00a0had hemophagocytosis but now without parasites. Corticotherapy was increased and intravenous Immunoglobulin was started, with\u00a0improvement. Rituximab was started as a result of macrophage activation syndrome and diffuse alveolar hemorrhage. Months after\u00a0discharge, she began once again to have sustained fever and Leishmania parasites were found again, therefore liposomal amphotericin\u00a0B was started once more associated with miltefosine. She continues being followed-up as she is asymptomatic and using steroidsin weaning scheme.<\/jats:p>","DOI":"10.20344\/amp.9028","type":"journal-article","created":{"date-parts":[[2018,10,31]],"date-time":"2018-10-31T22:44:51Z","timestamp":1541025891000},"page":"593-596","source":"Crossref","is-referenced-by-count":3,"title":["Visceral Leishmaniasis Associated with Macrophage Activation Syndrome and Diffuse Alveolar Hemorrhage in a Lupus Patient"],"prefix":"10.20344","volume":"31","author":[{"given":"Andreia","family":"Costa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e1rmen","family":"Pais","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Cerqueira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Salvador","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"8464","published-online":{"date-parts":[[2018,10,31]]},"container-title":["Acta M\u00e9dica Portuguesa"],"original-title":[],"link":[{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/9028\/5520","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/9028\/5520","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T08:33:23Z","timestamp":1666686803000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/view\/9028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,31]]},"references-count":0,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,10,31]]}},"URL":"https:\/\/doi.org\/10.20344\/amp.9028","relation":{},"ISSN":["1646-0758","0870-399X"],"issn-type":[{"value":"1646-0758","type":"electronic"},{"value":"0870-399X","type":"print"}],"subject":[],"published":{"date-parts":[[2018,10,31]]}}}