Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with Polyangiitis
Granulomatosis with polyangiitis (GPA) is a systemic granulomatous inflammatory disease characterized by small-to-medium vessel vasculitis due to Central Anti-Neutrophil Cytoplasmic Antibody (C-ANCA). GPA commonly involves the lungs and the kidneys. Among the pulmonary manifestations, diffuse alveol...
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| Format: | Article |
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MDPI AG
2019-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/55/7/378 |
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| author | Yasar Sattar Ammu Thampi Susheela Waqas Ullah Norina Usman Fnu Zafrullah |
| author_facet | Yasar Sattar Ammu Thampi Susheela Waqas Ullah Norina Usman Fnu Zafrullah |
| author_sort | Yasar Sattar |
| collection | DOAJ |
| description | Granulomatosis with polyangiitis (GPA) is a systemic granulomatous inflammatory disease characterized by small-to-medium vessel vasculitis due to Central Anti-Neutrophil Cytoplasmic Antibody (C-ANCA). GPA commonly involves the lungs and the kidneys. Among the pulmonary manifestations, diffuse alveolar hemorrhage (DHA) is a rare presentation of GPA that can present with hemoptysis leading to acute onset of anemia and hemodynamic instability. An active diagnostic workup including serologic titer of C-ANCA, imaging, intensive care, and aggressive immunosuppression is the key to DAH management. We report a case of DAH secondary to GPA that presented with hemoptysis leading to severe anemia, initially resuscitated symptomatically and started on plasmapheresis with pulse steroids and cyclophosphamide. Timely diagnosis and management led to a remarkable recovery of the pulmonary symptoms and imaging findings of DAH. |
| first_indexed | 2024-03-12T06:14:05Z |
| format | Article |
| id | doaj.art-cfe26001c8c74136926d61daa076b90b |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T06:14:05Z |
| publishDate | 2019-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-cfe26001c8c74136926d61daa076b90b2023-09-03T02:47:28ZengMDPI AGMedicina1010-660X2019-07-0155737810.3390/medicina55070378medicina55070378Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with PolyangiitisYasar Sattar0Ammu Thampi Susheela1Waqas Ullah2Norina Usman3Fnu Zafrullah4Icahn School of Medicine at Mount Sinai-Elmhurst Hospital, Queens, NY 11373, USABeth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USAAbington Hospital Jefferson Health, Abington, PA 19001, USALasante Health Clinic, Brooklyn, NY 11226, USASteward Carney Hospital, Tufts Medical Center, Boston, MA 02111, USAGranulomatosis with polyangiitis (GPA) is a systemic granulomatous inflammatory disease characterized by small-to-medium vessel vasculitis due to Central Anti-Neutrophil Cytoplasmic Antibody (C-ANCA). GPA commonly involves the lungs and the kidneys. Among the pulmonary manifestations, diffuse alveolar hemorrhage (DHA) is a rare presentation of GPA that can present with hemoptysis leading to acute onset of anemia and hemodynamic instability. An active diagnostic workup including serologic titer of C-ANCA, imaging, intensive care, and aggressive immunosuppression is the key to DAH management. We report a case of DAH secondary to GPA that presented with hemoptysis leading to severe anemia, initially resuscitated symptomatically and started on plasmapheresis with pulse steroids and cyclophosphamide. Timely diagnosis and management led to a remarkable recovery of the pulmonary symptoms and imaging findings of DAH.https://www.mdpi.com/1010-660X/55/7/378diffuse alveolar hemorrhagegranulomatosis with polyangiitisplasmapheresisprednisonecyclophosphamiderituximab |
| spellingShingle | Yasar Sattar Ammu Thampi Susheela Waqas Ullah Norina Usman Fnu Zafrullah Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with Polyangiitis Medicina diffuse alveolar hemorrhage granulomatosis with polyangiitis plasmapheresis prednisone cyclophosphamide rituximab |
| title | Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with Polyangiitis |
| title_full | Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with Polyangiitis |
| title_fullStr | Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with Polyangiitis |
| title_full_unstemmed | Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with Polyangiitis |
| title_short | Use of Plasmapheresis and Immunosuppressants to Treat Diffuse Alveolar Hemorrhage in a Patient with Granulomatosis with Polyangiitis |
| title_sort | use of plasmapheresis and immunosuppressants to treat diffuse alveolar hemorrhage in a patient with granulomatosis with polyangiitis |
| topic | diffuse alveolar hemorrhage granulomatosis with polyangiitis plasmapheresis prednisone cyclophosphamide rituximab |
| url | https://www.mdpi.com/1010-660X/55/7/378 |
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