[Intra-alveolar hemorrhage in Wegener's granulomatosis. Retrospective study of 9 cases].
Among 66 patients with Wegener's granulomatosis, 9 had an intra-alveolar haemorrhage which revealed the disease. The diagnosis was based on dyspnoea (n = 9), haemoptysis (n = 9) and anaemia (n = 9) with a mean haemoglobin level of 8 +/- 1 g/dl. Radiology showed bilateral alveolar infiltrates (n = 9), and numerous siderophages were found either in the alveolar lavage fluid (n = 7/7) or in sputum (n = 2). In every case, the alveolar haemorrhage was accompanied by a rapidly progressive extracapillary glomerulonephritis and by lesions of the upper airways which preceded it by several months or years. All patients received corticosteroids combined, in 8 cases, with cyclophosphamide. The respiratory disease improved rapidly, in contrast with the renal disease which became worse (n = 5). Two patients died in the acute phase of the vasculitis: one of acute renal failure, the other of infectious shock.
Service de Médecine interne, Groupe hospitalier Pitié-Salpêtrière, Paris.
F
F
Sauvaget
D u
Du
Lê Thi Huong
J C
JC
Piette
B
B
Wechsler
O
O
Blétry
T
T
Papo
P
P
Godeau
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006470:Hemorrhage / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011650:Pulmonary Alveoli; D012189:Retrospective Studies; D013997:Time Factors
D011241:Prednisone; D008775:Methylprednisolone
Hémorragies intra-alvéolaires de la granulomatose de Wegener. Etude rétrospective de 9 cas.