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A severe pleural complication associated with granulomatosis with polyangiitis
Melanie Chin1,2, Aaron Leblanc3, Carolina Souza4,2
1Division of Respirology, Department of Medicine, University of Ottawa, Canada.
Respiratory Medicine Case Reports
|November 1, 2019
Summary
Granulomatosis with Polyangiitis (GPA) can cause rare pleural complications like pneumothorax and empyema, even after treatment begins. Clinicians should monitor patients closely for these serious conditions.
Area of Science:
- Pulmonology
- Rheumatology
- Critical Care Medicine
Background:
- Granulomatosis with Polyangiitis (GPA) is a rare autoimmune vasculitis affecting small to medium-sized blood vessels.
- GPA commonly involves the respiratory tract and kidneys, but can affect other organs.
Observation:
- A previously healthy male presented with sinusitis, pulmonary cavities, and hemoptysis, leading to a GPA diagnosis.
- Following immunosuppressive treatment initiation for GPA, the patient developed a large pneumothorax complicated by empyema.
Findings:
- This case highlights rare pleural complications, specifically pneumothorax and empyema, as potential manifestations of Granulomatosis with Polyangiitis.
- These pleural events occurred despite the initiation of disease-modifying immunosuppressive therapy for GPA.
Implications:
- Clinicians should maintain a high index of suspicion for pleural complications in GPA patients.
- Vigilant monitoring for pneumothorax and empyema is crucial, even after commencing immunosuppressive treatment for Granulomatosis with Polyangiitis.
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