[Diffuse alveolar hemorrhage in isolated pulmonary capillaritis--case report].
BACKGROUND
Pulmonary capillaritis is a small-diameter vessel vasculitis of the lung, which may occur in isolation as in isolated pauci-immune capillaritis, usually associated with the systemic vasculitis but it could be also related to collagen vascular diseases and in lung transplant rejection. Pulmonary capillaritis leads to diffuse alveolar hemorrhage.The clinical presentation includes symptoms like dyspnea, cough, pleuritic chest pain, fever and hemoptysis.


METHODS
A 48 year-old female patient, smoker, presented with progressive dyspnea. Serum tests for infectious diseases, collagen disorders and vasculitis were negative. Radiography and computed tomography of the chest showed diffuse alveolar infiltrates. Cytology of bronchoalveolar lavage showed presence of siderophages. A thoracoscopic lung biopsy was performed to clarify the diagnosis.The histopathological findings showed capillaritis and diffuse intraalveolar hemorrhage. Patient was treated with steroids, and good clinical and minimal radiographic response was obtained. Recently described pauci-immune pulmonary capillaritis has been characterized as p-ANCA (antineutrophil cytoplasmic antibodies) negative isolated pulmonary capillaritis.


CONCLUSIONS
Isolated pauci-immune pulmonary capillaritis is a rare disease. First clinical manifestations of the isolated pulmonary capillaritis were the symptoms of progressive dyspnea, radiographic and functional signs of the interstitial fibrosis. At the same time, the signs of extrapulmonary diseases were not found. Presence of siderophages in bronchoalveolar lavage indicated alveolar hemorrhage. Histopathological tests of the sample of the lung pointed to pulmonary capillaritis and intraalveolar hemorrhage. Prolonged treatment with corticosteroids was necessary.
Milić
M
Medenica
Miras
M
Medenica
D002196:Capillaries / Q000000981:diagnostic imaging / Q000473:pathology; D004417:Dyspnea / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000209:etiology; D006470:Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008171:Lung Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014657:Vasculitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology
D005938:Glucocorticoids