1. [Diffuse alveolar hemorrhage in isolated pulmonary capillaritis--case report].
- Author
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Medenica M and Medenica M
- Subjects
- Capillaries diagnostic imaging, Capillaries pathology, Dyspnea diagnostic imaging, Dyspnea etiology, Female, Glucocorticoids therapeutic use, Hemoptysis diagnostic imaging, Hemoptysis etiology, Hemorrhage diagnostic imaging, Hemorrhage drug therapy, Hemorrhage pathology, Humans, Lung Diseases diagnostic imaging, Lung Diseases drug therapy, Middle Aged, Pulmonary Alveoli diagnostic imaging, Pulmonary Alveoli pathology, Tomography, X-Ray Computed, Vasculitis diagnostic imaging, Vasculitis drug therapy, Vasculitis pathology, Hemorrhage complications, Lung Diseases complications, Vasculitis complications
- Abstract
Introduction: Pulmonary capillaritis is a small-diameter vessel vasculitis of the lung, which may occur in isolation as in isolated pauci-immune capillaritis, usually associated with the systemic vasculitis but it could be also related to collagen vascular diseases and in lung transplant rejection. Pulmonary capillaritis leads to diffuse alveolar hemorrhage.The clinical presentation includes symptoms like dyspnea, cough, pleuritic chest pain, fever and hemoptysis., Case Outline: A 48 year-old female patient, smoker, presented with progressive dyspnea. Serum tests for infectious diseases, collagen disorders and vasculitis were negative. Radiography and computed tomography of the chest showed diffuse alveolar infiltrates. Cytology of bronchoalveolar lavage showed presence of siderophages. A thoracoscopic lung biopsy was performed to clarify the diagnosis.The histopathological findings showed capillaritis and diffuse intraalveolar hemorrhage. Patient was treated with steroids, and good clinical and minimal radiographic response was obtained. Recently described pauci-immune pulmonary capillaritis has been characterized as p-ANCA (antineutrophil cytoplasmic antibodies) negative isolated pulmonary capillaritis., Conclusion: Isolated pauci-immune pulmonary capillaritis is a rare disease. First clinical manifestations of the isolated pulmonary capillaritis were the symptoms of progressive dyspnea, radiographic and functional signs of the interstitial fibrosis. At the same time, the signs of extrapulmonary diseases were not found. Presence of siderophages in bronchoalveolar lavage indicated alveolar hemorrhage. Histopathological tests of the sample of the lung pointed to pulmonary capillaritis and intraalveolar hemorrhage. Prolonged treatment with corticosteroids was necessary.
- Published
- 2014
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