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Unilateral diffuse alveolar haemorrhage with microscopic polyangiitis: A case report
Tae Gyoung Kim1, Jiyeon Kang2, Woo Jung Seo2
1Department of Internal Medicine Inje University Ilsan Paik Hospital Goyang Republic of Korea.
Respirology Case Reports
|February 13, 2023
Summary
Diffuse alveolar haemorrhage (DAH) is a serious lung condition. Early diagnosis of DAH, particularly when linked to ANCA-associated vasculitis, is crucial for effective treatment and improved patient outcomes.
Area of Science:
- Pulmonary Medicine
- Rheumatology
- Internal Medicine
Background:
- Diffuse alveolar haemorrhage (DAH) is a critical condition characterized by widespread pulmonary small vessel damage.
- Chest imaging typically reveals bilateral diffuse airspace opacities in DAH patients.
- Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, such as microscopic polyangiitis, is a key differential diagnosis for DAH.
Observation:
- A 78-year-old woman presented with unilateral DAH, severe dyspnea, and anemia.
- Bronchoalveolar lavage confirmed DAH.
- Laboratory findings included positive ANCA and anti-myeloperoxidase antibodies, leading to a diagnosis of microscopic polyangiitis.
Findings:
- Treatment with rituximab and methylprednisolone resulted in significant improvement.
- The patient's symptoms, laboratory values, and chest radiography findings all showed positive response to therapy.
Implications:
- This case underscores the necessity of prompt clinical recognition of DAH symptoms like dyspnea and anemia.
- Early diagnosis and treatment initiation are vital for managing DAH, especially when associated with ANCA-vasculitis.
- Highlights the importance of considering microscopic polyangiitis in patients presenting with DAH symptoms.
