Surgical lung biopsy to diagnose Behcet′s vasculitis with adult respiratory distress syndrome
A 34-year-old female presented with fever and abdominal pain. Past medical history includes Crohn′s and Behcet′s disease. Examination revealed multiple skin ulcerations, oral aphthae, and bilateral coarse rales. She developed respiratory distress with diffuse bilateral alveolar infiltrates on chest...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Lung India |
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| Online Access: | http://www.lungindia.com/article.asp?issn=0970-2113;year=2014;volume=31;issue=4;spage=387;epage=389;aulast=Vydyula |
| _version_ | 1811259928993595392 |
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| author | Ravikanth Vydyula Charles Allred Mariana Huartado Bushra Mina |
| author_facet | Ravikanth Vydyula Charles Allred Mariana Huartado Bushra Mina |
| author_sort | Ravikanth Vydyula |
| collection | DOAJ |
| description | A 34-year-old female presented with fever and abdominal pain. Past medical history includes Crohn′s and Behcet′s disease. Examination revealed multiple skin ulcerations, oral aphthae, and bilateral coarse rales. She developed respiratory distress with diffuse bilateral alveolar infiltrates on chest radiograph requiring intubation. PaO 2 /FiO 2 ratio was 132. The chest computed tomography revealed extensive nodular and patchy ground-glass opacities. Bronchoalveolar lavage demonstrated a predominance of neutrophils. Methylprednisolone 60 mg every 6 h and broad-spectrum antimicrobials were initiated. No infectious etiologies were identified. Surgical lung biopsy demonstrated diffuse alveolar damage (DAD) mixed with lymphocytic and necrotizing vasculitis with multiple small infarcts and thrombi consistent with Behcet′s vasculitis. As she improved, steroids were tapered and discharged home on oral cyclophosphamide. Pulmonary involvement in Behcet′s is unusual and commonly manifests as pulmonary artery aneurysms, thrombosis, infarction, and hemorrhage. Lung biopsy findings demonstrating DAD are consistent with the clinical diagnosis of adult respiratory distress syndrome. The additional findings of necrotizing vasculitis and infarcts may have led to DAD. |
| first_indexed | 2024-04-12T18:40:01Z |
| format | Article |
| id | doaj.art-bbcb1e0db3024050be68a4ebced8badc |
| institution | Directory Open Access Journal |
| issn | 0970-2113 0974-598X |
| language | English |
| last_indexed | 2024-04-12T18:40:01Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Lung India |
| spelling | doaj.art-bbcb1e0db3024050be68a4ebced8badc2022-12-22T03:20:50ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2014-01-0131438738910.4103/0970-2113.142127Surgical lung biopsy to diagnose Behcet′s vasculitis with adult respiratory distress syndromeRavikanth VydyulaCharles AllredMariana HuartadoBushra MinaA 34-year-old female presented with fever and abdominal pain. Past medical history includes Crohn′s and Behcet′s disease. Examination revealed multiple skin ulcerations, oral aphthae, and bilateral coarse rales. She developed respiratory distress with diffuse bilateral alveolar infiltrates on chest radiograph requiring intubation. PaO 2 /FiO 2 ratio was 132. The chest computed tomography revealed extensive nodular and patchy ground-glass opacities. Bronchoalveolar lavage demonstrated a predominance of neutrophils. Methylprednisolone 60 mg every 6 h and broad-spectrum antimicrobials were initiated. No infectious etiologies were identified. Surgical lung biopsy demonstrated diffuse alveolar damage (DAD) mixed with lymphocytic and necrotizing vasculitis with multiple small infarcts and thrombi consistent with Behcet′s vasculitis. As she improved, steroids were tapered and discharged home on oral cyclophosphamide. Pulmonary involvement in Behcet′s is unusual and commonly manifests as pulmonary artery aneurysms, thrombosis, infarction, and hemorrhage. Lung biopsy findings demonstrating DAD are consistent with the clinical diagnosis of adult respiratory distress syndrome. The additional findings of necrotizing vasculitis and infarcts may have led to DAD.http://www.lungindia.com/article.asp?issn=0970-2113;year=2014;volume=31;issue=4;spage=387;epage=389;aulast=VydyulaAdult respiratory distress syndromeBehcet′s diseaseBehcet′s vasculitisdiffuse alveolar damagelung injuryvasculitis |
| spellingShingle | Ravikanth Vydyula Charles Allred Mariana Huartado Bushra Mina Surgical lung biopsy to diagnose Behcet′s vasculitis with adult respiratory distress syndrome Lung India Adult respiratory distress syndrome Behcet′s disease Behcet′s vasculitis diffuse alveolar damage lung injury vasculitis |
| title | Surgical lung biopsy to diagnose Behcet′s vasculitis with adult respiratory distress syndrome |
| title_full | Surgical lung biopsy to diagnose Behcet′s vasculitis with adult respiratory distress syndrome |
| title_fullStr | Surgical lung biopsy to diagnose Behcet′s vasculitis with adult respiratory distress syndrome |
| title_full_unstemmed | Surgical lung biopsy to diagnose Behcet′s vasculitis with adult respiratory distress syndrome |
| title_short | Surgical lung biopsy to diagnose Behcet′s vasculitis with adult respiratory distress syndrome |
| title_sort | surgical lung biopsy to diagnose behcet s vasculitis with adult respiratory distress syndrome |
| topic | Adult respiratory distress syndrome Behcet′s disease Behcet′s vasculitis diffuse alveolar damage lung injury vasculitis |
| url | http://www.lungindia.com/article.asp?issn=0970-2113;year=2014;volume=31;issue=4;spage=387;epage=389;aulast=Vydyula |
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