[Wegener granulomatosis with severe alveolar hemorrhagic syndrome].
The article presents the case of a female admitted for the suspicion of pulmonary TB (clinical and radiological pattern compatible with this diagnosis), in which the lack of bacteriological confirmation together with a rapid and dramatic deterioration of clinical, radiological and functional status excluded tuberculosis and oriented the diagnosis towards a severe alveolar hemorrhage; further tests confirmed a Wegener granulomatosis with pulmonary, renal and ORL manifestations. The evolution was rapidly favorable using pulse-therapy with cyclophosphamide and methylprednisolone i.v. The particularities of this case were: the use of helmet device for correction of the extremely severe hypoxemia for 3 weeks (no other studies reported such a long continuous duration of use of this device) and the lag between the pulmonary and the renal impairment.
Macri
Anca
A
Institutul de Pneumologie Marius Nasta, sectia pneumologie II. ancamacri@yahoo.com
Stoica
Radu
R
Ion
Iolanda
I
Dănilă
Eduard
E
Tănăseanu
Stefănită
S
D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006470:Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007275:Injections, Intravenous; D007674:Kidney Diseases / Q000209:etiology; D008171:Lung Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage; D011650:Pulmonary Alveoli; D020551:Pulse Therapy, Drug; D013577:Syndrome; D016896:Treatment Outcome
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D010100:Oxygen; D008775:Methylprednisolone