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Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with Polyangiitis

Authors :
Fnu Zafrullah
Ammu Susheela
Yasar Sattar
Norina Usman
Waqas Ullah
Source :
Medicina, Medicina, Vol 55, Iss 7, p 378 (2019)
Publication Year :
2019
Publisher :
MDPI AG, 2019.

Abstract

Granulomatosis with polyangiitis (GPA) is a systemic granulomatous inflammatory disease characterized by small-to-medium vessel vasculitis due to Central Anti-Neutrophil Cytoplasmic Antibody (C-ANCA). GPA commonly involves the lungs and the kidneys. Among the pulmonary manifestations, diffuse alveolar hemorrhage (DHA) is a rare presentation of GPA that can present with hemoptysis leading to acute onset of anemia and hemodynamic instability. An active diagnostic workup including serologic titer of C-ANCA, imaging, intensive care, and aggressive immunosuppression is the key to DAH management. We report a case of DAH secondary to GPA that presented with hemoptysis leading to severe anemia, initially resuscitated symptomatically and started on plasmapheresis with pulse steroids and cyclophosphamide. Timely diagnosis and management led to a remarkable recovery of the pulmonary symptoms and imaging findings of DAH.

Details

ISSN :
16489144
Volume :
55
Database :
OpenAIRE
Journal :
Medicina
Accession number :
edsair.doi.dedup.....c706aefd879ba449c0b28826982a9eb6
Full Text :
https://doi.org/10.3390/medicina55070378