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

被引：1

作者：

Watanabe, Chiaki ^{[1
]}

Fukui, Shoichi ^{[1
]}

Iwamoto, Naoki ^{[1
]}

Shimizu, Toshimasa ^{[1
]}

Umeda, Masataka ^{[1
]}

Nishino, Ayako ^{[1
]}

Koga, Tomohiro ^{[1
]}

Kawashiri, Shin-ya ^{[1
,2
]}

Ichinose, Kunihiro ^{[1
]}

Hirai, Yasuko ^{[1
]}

Tamai, Mami ^{[1
]}

Nakamura, Hideki ^{[1
]}

Origuchi, Tomoki ^{[1
,3
]}

Tabata, Kazuhiro ^{[4
]}

Kawakami, Atsushi ^{[1
]}

机构：

[1] Nagasaki Univ, Unit Adv Prevent Med Sci, Dept Immunol & Rheumatol, Grad Sch Biomed Sci, Nagasaki, Japan

[2] Nagasaki Univ, Unit Adv Prevent Med Sci, Dept Community Med, Grad Sch Biomed Sci, Nagasaki, Japan

[3] Nagasaki Univ, Unit Rehabil Sci, Dept Locomot Rehabil Sci, Grad Sch Biomed Sci, Nagasaki, Japan

[4] Nagasaki Univ Hosp, Dept Pathol, Nagasaki, Japan

来源：

INTERNAL MEDICINE | 2018年 / 57卷 / 03期

关键词：

diffuse alveolar hemorrhage; granulomatosis with polyangiitis; intravenous pulse methylprednisolone; intravenous cyclophosphamide pulse therapy; ANCA associated vasculitis; ANCA-ASSOCIATED VASCULITIS; THERAPY;

D O I：

10.2169/internalmedicine.9188-17

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：417 / 421

页数：5

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