C3 and heart failure: Among the multiple risk factors for alveolar hemorrhage that the patient did have were development thrombocytopenia and leukopenia, low C3 levels, high (ds)DNA levels, severe disease activity, and lupus nephritis.4,14 Finally, heart failure, in this case, could be associated with the pulmonary vasculature occlusion severity, which could have led to a right ventricular failure and a subsequent acute circulatory collapse.