We will be reviewing the cases of three (3) women hospitalized at one polyvalent ICU with a diagnosis of systemic erythematosus lupus (SEL) and diffuse alveolar hemorrhage (DAH). One point-of-care ultrasound device with a 3.5mHz convex transducer was used in the supine position with the patients’ heads inclined in a 30° angle and four (4) areas in each hemithorax were assessed, three (3) with mechanical ventilatory support. The lung pattern was “A” in the eight (8) areas assessed. Images 1A, 2A and 3A correspond to the Pulmonary ultrasound on right sector 3 (superior and lateral) and show the two-dimensional mode (B) with “A” lines and motion mode (M)–the “seashore” sign; panels B and C correspond to the simple CT scan and the X-ray (point-of-care, same position). The normal finding would be the alveolar-interstitial pattern with a great amount of “B” lines due to subpleural air entrapment in DAH and heterogeneous distribution, which leads to false negatives (Fig. 1).

Figure 1

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