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P-ANCA vasculitis with diffuse alveolar haemorrhage preceded by a spider bite
Ali Hameed Ali1, Mandip Singh Kang2, Jaafar Aldahwi3
1Internal Medicine, UCSF, Fresno, California, USA.
BMJ Case Reports
|June 20, 2020
Summary
Black widow spider bites may precede ANCA vasculitis, a condition causing lung hemorrhage. Prompt treatment with steroids and rituximab led to successful recovery.
Area of Science:
- Immunology
- Rheumatology
- Toxicology
Background:
- Antineutrophilic cytoplasmic antibody (ANCA) vasculitis is a serious autoimmune condition.
- Black widow spider envenomation can cause various systemic symptoms.
Observation:
- A patient presented with a skin rash following black widow spider bites.
- Symptoms progressed to include hemoptysis and acute hypoxic respiratory failure.
Findings:
- Elevated peri-nuclear ANCA titers were detected.
- Bronchoscopy confirmed diffuse alveolar hemorrhage.
- The patient's condition was successfully managed with methylprednisolone and rituximab.
Implications:
- This case suggests a potential link between black widow spider bites and the development of ANCA vasculitis.
- Early recognition and aggressive immunosuppressive therapy are crucial for managing this severe presentation.
- Further research may elucidate the immunological mechanisms connecting spider bites to vasculitis.
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