scholarly journals Antineutrophil Cytoplasmic Antibody-associated Vasculitis With Alveolar Hemorrhage and Ruptured Renal Aneurysm: a Case Report and Literature Review

2021 ◽  
Author(s):  
Wang Deng ◽  
Zhi-Yu Zhou ◽  
Xi Liu ◽  
Xiao-Qing Luo ◽  
Jin Tong ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Lower Lobe ◽  
Arterial Embolization ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Alveolar Hemorrhage ◽  
Small Vessel Vasculitis ◽  
Case Presentation ◽  
Renal Aneurysm ◽  
Antineutrophil Cytoplasmic Autoantibody ◽  
Life Threatening

Abstract Background: Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) is characterized by necrotizing damage of small -vessel vasculitis and the main violation of the kidney or lung. Manifestation of alveolar hemorrhage and renal aneurysm is extremely rare in Granulomatosis with polyangiitis (GPA).Case presentation: A 50-year-old Chinese man was admitted due to repeated cough, expectoration, fever and shortness of breath. A chest computed tomography (CT) scan showed bilateral infiltrates in the lower lobe of the lung. GPA was considered based on the pulmonary capillaritis, alveolar hemorrhage, renal insufficiency and cANCA -PR3 positivity. Immunosuppressive therapy combined with plasma exchange (PE) was performed. The patient suffered from a rupture of renal aneurysm. Though selective renal arterial embolization was performed, the patient had a poor outcome. Conclusions: GPA could be life-threatening, especially large vessel vasculitis involved. The possibility of aneurysmal rupture should be carefully considered and checked frequently in the condition of immunosuppressive therapy.

Life-threatening antineutrophil cytoplasmic antibody–associated vasculitis after influenza A H1N1 infection requiring veno-venous extracorporeal membrane oxygenation

Perfusion ◽  
2020 ◽  
Vol 35 (6) ◽  
pp. 546-549
Author(s):  
Frantzeska G. Frantzeskaki ◽  
Stavros Dimopoulos ◽  
Dimitrios Konstantonis ◽  
Pelagia Katsibri ◽  
Kostantinos Kostopanagiotou ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Influenza A ◽  
Immunosuppressive Treatment ◽  
Pulmonary Hemorrhage ◽  
Antineutrophil Cytoplasmic Antibody ◽  
H1n1 Infection ◽  
Membrane Oxygenation ◽  
Antineutrophil Cytoplasmic Autoantibody ◽  
Influenza A H1n1 ◽  
Life Threatening

Introduction: Antineutrophil cytoplasmic autoantibody–associated vasculitis is an immune-mediated necrotizing vasculitis, affecting small- and medium-sized vessels. Case report: A 22-year-old female patient with free medical history presented with life-threatening pulmonary hemorrhage due to antineutrophil cytoplasmic autoantibody–associated vasculitis, temporarily associated with influenza A H1N1 infection. Due to rapidly worsening respiratory failure, despite conventional management, veno-venous peripheral extracorporeal membrane oxygenation was initiated and continued for 26 days, with subsequent renal replacement therapy. Discussion: We present a case of severe antineutrophil cytoplasmic autoantibody–associated pulmonary vasculitis, managed with veno-venous extracorporeal membrane oxygenation at the initial phase. Despite the significant challenges raised with the use of extracorporeal membrane oxygenation in pulmonary hemorrhage cases, extracorporeal membrane oxygenation may have a significant impact on outcome in this setting, by providing adequate time for a successful immunosuppressive treatment.

scholarly journals Antineutrophil cytoplasmic antibody-associated vasculitis with alveolar hemorrhage and ruptured renal aneurysm

Medicine ◽  
2022 ◽  
Vol 101 (1) ◽  
pp. e28543
Author(s):  
Jin Tong ◽  
Zhi-Yu Zhou ◽  
Xi Liu ◽  
Dao-Xin Wang ◽  
Wang Deng
Keyword(s):  
Antineutrophil Cytoplasmic Antibody ◽  
Alveolar Hemorrhage ◽  
Renal Aneurysm

Primary Choriocarcinoma of the Lung Manifesting as Diffuse Alveolar Hemorrhage

2006 ◽  
Vol 130 (4) ◽  
pp. 540-543
Author(s):  
Masayuki Shintaku ◽  
Moon Hee Hwang ◽  
Ryoichi Amitani
Keyword(s):  
Venous Pressure ◽  
Lower Lobe ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Pulmonary Vasculature ◽  
Small Vessel Vasculitis ◽  
Progressive Dyspnea ◽  
Pathologic Features ◽  
Entire Lung ◽  
The Right

Abstract An autopsy case of primary pulmonary choriocarcinoma that manifested as diffuse alveolar hemorrhage is reported. A 44-year-old nurse presented with fever, dry cough, hemoptysis, and progressive dyspnea, and died after a downhill course of 2 weeks. Chest radiographs showed diffuse parenchymal shadows throughout the entire lung and a nodular lesion in the right lower lobe. Findings suggestive of acute renal failure were not seen. The autopsy revealed primary pure choriocarcinoma of the right lower lobe and diffuse alveolar hemorrhage throughout the entire lung. Findings of small vessel vasculitis (“pulmonary alveolar capillaritis”) were not observed, and extensive neoplastic involvement of the pulmonary vasculature was considered the cause of the diffuse alveolar hemorrhage. Small metastatic foci were found in the liver, adrenal glands, pancreas, and ovaries. This case shows that primary pulmonary neoplasms, on rare occasions, can produce the clinical and pathologic features of diffuse alveolar hemorrhage, probably through elevated pulmonary venous pressure caused by extensive destruction of the vasculature.

scholarly journals Failure of Recombinant Activated Factor VII in Treatment of Diffuse Alveolar Hemorrhage due to Cryoglobulinemic Vasculitis

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Dania Khoulani ◽  
Bharat Rao ◽  
Ammar Khanshour ◽  
Philip Kuriakose ◽  
Lenar Yessayan
Keyword(s):  
Case Reports ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Factor Vii ◽  
Small Vessel Vasculitis ◽  
Cryoglobulinemic Vasculitis ◽  
Recombinant Activated Factor Vii ◽  
Randomized Controlled ◽  
Activated Factor Vii ◽  
Life Threatening

Diffuse alveolar hemorrhage (DAH) is a serious complication of the small vessel vasculitis syndromes and carries a high mortality. Recombinant activated factor VII (rFVIIa) is used to treat bleeding in patients with hemophilia and antibodies to factor VIII or IX. It is increasingly being used in life-threatening hemorrhage in a variety of other settings in which conventional therapy is unsuccessful. Randomized controlled trials of rFVIIa in DAH are lacking. However, several case reports have described a complete or sustained control of DAH using rFVIIa after patients failed to respond to medical treatment. There are no case reports in the literature describing the use or the failure of rFVIIa in DAH associated with cryoglobulinemic vasculitis. We here report the failure of rFVIIa to control DAH in a patient with CD5+ B-cell non-Hodgkin’s lymphoma and cryoglobulinemic vasculitis.

scholarly journals Pediatric ANCA- Associated Vasculitis Presenting with Acute Postoperative Subglottic Stenosis: A Case Report

2021 ◽  
Vol 7 (1) ◽  
Keyword(s):  
Airway Disease ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Organ Damage ◽  
Young Female ◽  
Subglottic Stenosis ◽  
Case Presentation ◽  
Anca Associated Vasculitis ◽  
Clinical Presentations ◽  
Disease Case ◽  
Life Threatening

Introduction: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) often present with nonspecific constitutional symptoms. However, there has been increasing recognition of a subgroup of young, female AAV patients who are at higher risk for isolated subglottic airway disease. Case Presentation: We report a rare case of a 17-year-old female with undiagnosed ANCA-associated vasculitis who presents with acute, life threatening subglottic stenosis requiring emergent intubation after routine surgery. Conclusion: Much of the research on ANCA-associated vasculitis have been based on adult cases, however many pediatric patients may not follow the same diagnostic and clinical presentations. Clinicians should be vigilant in recognizing a subgroup of vasculitis patients who are often young, female, and have a higher prevalence of subglottic stenosis. Symptoms should be promptly worked up and initiation of immunosuppressive therapy is necessary to prevent life threatening complications and end-organ damage. Keywords: ANCA-associated vasculitis, Subglottic stenosis, Granulomatosis with polyangiitis.

Severe Alveolar Hemorrhage – What’s in it for the Gastroenterologist?

2016 ◽  
Vol 25 (4) ◽  
pp. 555-558
Author(s):  
Alina Popp
Keyword(s):  
Celiac Disease ◽  
International Normalized Ratio ◽  
Gluten Free Diet ◽  
Alveolar Hemorrhage ◽  
Severe Anemia ◽  
Gluten Free ◽  
Pulmonary Infiltrates ◽  
Pulmonary Hemosiderosis ◽  
Threatening Condition ◽  
Life Threatening

Background: Alveolar hemorrhage is a potentially life-threatening condition which is usually managed by the pulmonologist. When considering its etiology, there is a rare association that sets the disease into the hands of the gastroenterologist. Case presentation: We report the case of a 48 year-old female who was admitted to the intensive care unit for severe anemia and hemoptysis. On imaging, diffuse pulmonary infiltrates suggestive of alveolar hemorrhage were detected and a diagnosis of pulmonary hemosiderosis was made. She received cortisone therapy and hematologic correction of anemia, with slow recovery. In search of an etiology for the pulmonary hemosiderosis, an extensive workup was done, and celiac disease specific serology was found positive. After confirmation of celiac disease by biopsy, a diagnosis of Lane-Hamilton syndrome was established. The patient was recommended a gluten-free diet and at 6 months follow-up, resolution of anemia and pulmonary infiltrates were observed. Conclusion: Although the association is rare, celiac disease should be considered in a patient with idiopathic pulmonary hemosiderosis. In our case, severe anemia and alveolar infiltrates markedly improved with glucocorticoids and gluten-free diet. Abbreviations: APTT: activated partial thromboplastin time; BAL: bronchoalveolar lavage; CD: celiac disease; Cd: crypt depth; GFD: gluten-free diet; GI: gastrointestinal; IEL: intraepithelial lymphocyte; INR: international normalized ratio; IPH: idiopathic pu

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

scholarly journals Life-Threatening Subglottic Stenosis of Granulomatosis with Polyangiitis: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 423
Author(s):  
Jin An ◽  
Jae-Won Song
Keyword(s):  
Immunosuppressive Therapy ◽  
Granulomatosis With Polyangiitis ◽  
Granulomatous Inflammation ◽  
Subglottic Stenosis ◽  
Emergency Tracheostomy ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection ◽  
Life Threatening ◽  
Carbon Dioxide Co2 ◽  
Laryngotracheal Resection

Granulomatosis with polyangiitis (GPA) is an autoimmune disease characterized by necrotizing granulomatous inflammation. Subglottic stenosis, which is defined as narrowing of the airway below the vocal cords, has a frequency of 16–23% in GPA. Herein, we present the case of a 39-year-old woman with subglottic stenosis manifesting as life-threatening GPA, which was recurrent under systemic immunosuppressive therapy. The patient underwent an emergency tracheostomy, intratracheal intervention, such as carbon dioxide (CO2) laser surgery and intralesional steroid injection via laryngomicroscopic surgery, and laryngotracheal resection with remodeling. Severe subglottic stenosis treatment requires active intratracheal intervention, surgery, and systemic immunosuppressive therapy.

scholarly journals Ondine’s curse, a fatal infarction diagnosed by polysomnography and saved by ventilation: a case report

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Hany Aref ◽  
Tamer Roushdy ◽  
Amr Zaki ◽  
Nevine El Nahas
Keyword(s):  
Case Report ◽  
Diagnostic Procedure ◽  
Cardiac Pacemaker ◽  
Brainstem Infarction ◽  
Case Presentation ◽  
Ondine’S Curse ◽  
Lateral Medullary Syndrome ◽  
Life Threatening ◽  
Ondine's Curse

Abstract Background Lateral medullary syndrome causing Ondine’s curse is a rare yet fatal brainstem infarction. Any patient presenting with lateral medulla infarction ought to be well observed and a polysomnography must be ordered for him. Case presentation A patient presenting with Ondine’s curse is dealt with through polysomnography as a diagnostic procedure that was followed by tracheostomy with portable ventilator and cardiac pacemaker as a therapeutic maneuver which ultimately preserved his life. Conclusion Lateral medullary syndrome infarct could be a life-threatening stroke if not diagnosed and managed properly.

scholarly journals Two deaths due to explosion of cylinders of liquid petroleum gas

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nagendra Singh Sonwani ◽  
Navneet Ateriya ◽  
Arvind Kumar ◽  
Anil Kohli
Keyword(s):  
Blast Injuries ◽  
Air Conditioner ◽  
Liquefied Petroleum Gas ◽  
Case Presentation ◽  
Gas Cylinder ◽  
Liquid Petroleum Gas ◽  
Life Threatening ◽  
System Life ◽  
High Pressure Equipment ◽  
Coffee Machine

Abstract Background Cylinder blasts can inflict multi-system life-threatening injuries to one or many persons simultaneously if they are nearby. The explosion in high-pressure equipment produces injuries due to its varied effects. Cases have been reported where the blast occurred in balloon gas cylinder, oxyacetylene gas cylinder, oxygen cylinder, coffee machine, and compressor of a split air conditioner (AC). Most of the cases are accidental. The investigation into the blast circumstances is of utmost importance to find out the manner and device involved. Case presentation Here, we present a report of two cases where victims suffered blast injuries at the same location due to the explosion of two different capacity liquefied petroleum gas (LPG) domestic cylinder and died on the spot. Conclusion The investigation into the blast circumstances is of utmost importance to find out the manner and device involved. Malpractice involving use of cylinder to fill another one might be dangerous for the person involved and present in the vicinity. This practice should be discouraged by lay person.

Sign in / Sign up

Export Citation Format

Share Document