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


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Title: Diffuse Alveolar Hemorrhage Developing Immediately after Immunosuppressive Treatments in a Patient with Granulomatosis with Polyangiitis Who Had Pulmonary Nodules
Authors: 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
Issue Date: 1-Feb-2018
Publisher: 日本内科学会 / Japanese Society of Internal Medicine
Citation: Internal Medicine, 57(3), pp.417-421; 2018
Abstract: 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.
Keywords: ANCA associated vasculitis / Diffuse alveolar hemorrhage / Granulomatosis with polyangiitis / Intravenous cyclophosphamide pulse therapy / Intravenous pulse methylprednisolone
URI: http://hdl.handle.net/10069/38265
ISSN: 09182918
DOI: 10.2169/internalmedicine.9188-17
Rights: © 2018 by The Japanese Society of Internal Medicine
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/38265

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