Rapidly progressive pulmonary haemorrhage in a case of microscopic polyangiitis.
A 77-year-old gentleman, a holidaymaker in the area, presented with a 2-month history of cough productive of rust-coloured sputum and exertional dyspnoea. His initial chest x-ray showed bibasal interstitial shadowing. He then deteriorated rapidly to type 1 respiratory failure with acute renal failure. A CT chest showed bilateral alveolar haemorrhage. Testing for p-anti-neutrophil cytoplasmic antibody was strongly positive, with an anti-myeloperoxidase antibody titre of 198 units/ml (normal range 0-6 units/ml). A diagnosis of microscopic polyangitis was made. Following treatment with plasma exchange, cyclophosphamide and steroids, he made a good recovery.
James Paget University Hospital, Great Yarmouth, UK. jw.mackay@gmail.com
James
J
Mackay
D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D045422:Continuous Positive Airway Pressure; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use; D006470:Hemorrhage / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D055953:Microscopic Polyangiitis / Q000175:diagnosis* / Q000628:therapy; D009195:Peroxidase / Q000097:blood; D010951:Plasma Exchange; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
D019268:Antibodies, Antineutrophil Cytoplasmic; D005938:Glucocorticoids; D003520:Cyclophosphamide; D009195:Peroxidase