Sun Y, Zhou C, Zhao J, et al. - Researchers undertook this retrospective nested case–control study in a single-center cohort, to investigate clinical features as well as outcome in systemic lupus erythematosus (SLE) patients with diffuse alveolar hemorrhage (DAH). They also focused on risk factors and prognostic factors for DAH. This analysis involved 4,744 patients with SLE, with 94 cases of DAH, for an incidence rate estimated to be 2.0%. Experts found that the occurrence of DAH is possible in any stage of SLE but mostly in the early phase of disease course. Lupus nephritis (LN) was identified as the most frequent concomitant involvement at DAH diagnosis. Among lupus patients, the identified independent risk factors of DAH were: LN, anti-SSA positivity, thrombocytopenia and high C-reactive protein. Because of the observed high early mortality rate of DAH and little long-term damage, it was inferred that early diagnosis and intensive treatment may be beneficial for DAH patients, and cyclophosphamide-based therapy can represent a preferential option.