BACKGROUND: Diffuse alveolar hemorrhage (DAH) is a life-threatening disorder resulting in hemorrhage into the lungs due to a variety of reasons. The underlying etiology for DAH is broadly divided into immune and non-immune mediated causes. Rheumatological disorders account for a small number of cases. Although hemoptysis is one of the alarming symptoms of DAH, it is absent in a third of the cases. Diagnosis often requires a conglomerate of history, clinical, and laboratory investigation and radiological studies.

CASE REPORT: We describe a case of a 31-year-old female who had an atypical presentation of systemic lupus erythematosus (SLE) with primary lung involvement/DAH and no other organ involvement.

CONCLUSIONS: This case report illustrates the importance of awareness and early recognition of the complication that can prevent mortality.

Keywords: Bronchoalveolar Lavage Fluid, Hemorrhage, Lupus Erythematosus, Systemic