Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules

A 65-year-old man was diagnosed with granulomatosis with polyangiitis (GPA) based on the detection of high myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA), vasculitis and granulomas in a lung biopsy specimen and crescentic glomerulonephritis in a kidney biopsy specimen. Soon after th...

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Autores principales: Watanabe, Chiaki, Fukui, Shoichi, Iwamoto, Naoki, Shimizu, Toshimasa, Umeda, Masataka, Nishino, Ayako, Koga, Tomohiro, Kawashiri, Shin-ya, Ichinose, Kunihiro, Hirai, Yasuko, Tamai, Mami, Nakamura, Hideki, Origuchi, Tomoki, Tabata, Kazuhiro, Kawakami, Atsushi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827327/
https://www.ncbi.nlm.nih.gov/pubmed/29093401
http://dx.doi.org/10.2169/internalmedicine.9188-17
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author Watanabe, Chiaki
Fukui, Shoichi
Iwamoto, Naoki
Shimizu, Toshimasa
Umeda, Masataka
Nishino, Ayako
Koga, Tomohiro
Kawashiri, Shin-ya
Ichinose, Kunihiro
Hirai, Yasuko
Tamai, Mami
Nakamura, Hideki
Origuchi, Tomoki
Tabata, Kazuhiro
Kawakami, Atsushi
author_facet Watanabe, Chiaki
Fukui, Shoichi
Iwamoto, Naoki
Shimizu, Toshimasa
Umeda, Masataka
Nishino, Ayako
Koga, Tomohiro
Kawashiri, Shin-ya
Ichinose, Kunihiro
Hirai, Yasuko
Tamai, Mami
Nakamura, Hideki
Origuchi, Tomoki
Tabata, Kazuhiro
Kawakami, Atsushi
author_sort Watanabe, Chiaki
collection PubMed
description A 65-year-old man was diagnosed with granulomatosis with polyangiitis (GPA) based on the detection of high myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA), vasculitis and granulomas in a lung biopsy specimen and crescentic glomerulonephritis in a kidney biopsy specimen. Soon after the initiation of intravenous methylprednisolone pulse therapy (mPSL pulse) and intravenous cyclophosphamide pulse therapy (IVCY), the patient experienced cough and hemoptysis. Based on emerging anemia and bilateral diffuse lung consolidation on computed tomography, we judged that diffuse alveolar hemorrhage (DAH) was complicated by GPA. The patient's DAH improved following additional mPSL pulse and IVCY. Physicians should be aware of the possible occurrence of DAH, even when a patient's symptoms improve after mPSL pulse and IVCY.
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spelling pubmed-58273272018-02-28 Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules Watanabe, Chiaki Fukui, Shoichi Iwamoto, Naoki Shimizu, Toshimasa Umeda, Masataka Nishino, Ayako Koga, Tomohiro Kawashiri, Shin-ya Ichinose, Kunihiro Hirai, Yasuko Tamai, Mami Nakamura, Hideki Origuchi, Tomoki Tabata, Kazuhiro Kawakami, Atsushi Intern Med Case Report A 65-year-old man was diagnosed with granulomatosis with polyangiitis (GPA) based on the detection of high myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA), vasculitis and granulomas in a lung biopsy specimen and crescentic glomerulonephritis in a kidney biopsy specimen. Soon after the initiation of intravenous methylprednisolone pulse therapy (mPSL pulse) and intravenous cyclophosphamide pulse therapy (IVCY), the patient experienced cough and hemoptysis. Based on emerging anemia and bilateral diffuse lung consolidation on computed tomography, we judged that diffuse alveolar hemorrhage (DAH) was complicated by GPA. The patient's DAH improved following additional mPSL pulse and IVCY. Physicians should be aware of the possible occurrence of DAH, even when a patient's symptoms improve after mPSL pulse and IVCY. The Japanese Society of Internal Medicine 2017-11-01 2018-02-01 /pmc/articles/PMC5827327/ /pubmed/29093401 http://dx.doi.org/10.2169/internalmedicine.9188-17 Text en Copyright © 2018 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Watanabe, Chiaki
Fukui, Shoichi
Iwamoto, Naoki
Shimizu, Toshimasa
Umeda, Masataka
Nishino, Ayako
Koga, Tomohiro
Kawashiri, Shin-ya
Ichinose, Kunihiro
Hirai, Yasuko
Tamai, Mami
Nakamura, Hideki
Origuchi, Tomoki
Tabata, Kazuhiro
Kawakami, Atsushi
Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules
title Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules
title_full Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules
title_fullStr Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules
title_full_unstemmed Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules
title_short Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules
title_sort diffuse alveolar hemorrhage developing immediately after immunosuppressive treatments in a patient with granulomatosis with polyangiitis who had pulmonary nodules
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827327/
https://www.ncbi.nlm.nih.gov/pubmed/29093401
http://dx.doi.org/10.2169/internalmedicine.9188-17
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