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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A 53-Year-Old Man With Fever, Clubbing, Hemoptysis, and Rapid Onset of Respiratory Failure*

Sajive Aleyas, MD; Bobbak Vahid, MD; Paul E. Marik, MD, FCCP
Author and Funding Information

*From Thomas Jefferson University Hospital, Department of Pulmonary and Critical Care Medicine, Philadelphia, PA.

Correspondence to: Bobbak Vahid, MD, 834 Walnut St, Suite 650, Philadelphia, PA 19107; e-mail: bobbak.vahid@mail.tju.edu



Chest. 2007;131(6):1974-1977. doi:10.1378/chest.06-2059
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Extract

A 53-year-old man presented to the emergency department complaining of hemoptysis and a 3-month history of progressive dyspnea on exertion. He also reported a history of dry cough, malaise, anorexia, and 20-lb weight loss within the same time period. He smoked one pack of cigarettes per day for 30 years. His medical history was unremarkable. Occupational and family histories were noncontributory.

1Alarcón, GS (2000) Unclassified or undifferentiated connective tissue disease.Baillières Clin Rheumatol14,125-1372Bodolay, E, Csiki, Z, Szekanecz, Z, et al Five-year follow-up of 665 Hungarian patients with undifferentiated connective tissue disease (UCTD).Clin Exp Rheumatol2003;21,313-3203Collard, HR, Schwarz, MI Diffuse alveolar hemorrhage.Clin Chest Med2004;25,583-5924Horiki, T, Fuyuno, G, Ishii, M, et al Fatal alveolar hemorrhage in a patient with mixed connective tissue disease presenting polymyositis features.Intern Med1998;37,554-5605Kallenberg, CG Overlapping syndromes, undifferentiated connective tissue disease, and other fibrosing conditions.Curr Opin Rheumatol1995;7,568-5736Lakhanpal, S, Conn, DL, Lie, JT Clinical and prognostic significance of vasculitis as an early manifestation of connective tissue disease syndromesAnn Intern Med1984;101,743-7487Lee, C-K, Koh, J-H, Cha, H-S Pulmonary alveolar hemorrhage in patients with rheumatic disease in Korea.Scand J Rheumatol2000;29,288-2948Lee, H-K, Kim, DS, Yoo, B, et al Histopathologic pattern and clinical features of rheumatoid arthritis-associated interstitial lung disease.Chest2005;127,2019-20279Schwartz, MI, Zamora, MR, Hodges, TN, et al Isolated pulmonary capillaritis and diffuse alveolar hemorrhage in rheumatoid arthritis and mixed connective tissue disease.Chest1998;113,1609-161510Travis, WD, Colby, TV, Lombard, C, et al A clinicopathologic study of 34 cases of diffuse pulmonary hemorrhage with lung biopsy conformation.Am J Surg Pathol1990;14,112-1125

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