SESSION TITLE: Fellow Case Report Poster - Diffuse Lung Disease II
SESSION TYPE: Affiliate Case Report Poster
PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM
INTRODUCTION: Pulmonary hemorrhage is a medical emergency with high mortality. Rapid diagnosis and timely initiation of immunosuppressive therapy are key to management.
CASE PRESENTATION: An 83 year old female with history of hypertension was admitted for worsening renal failure. Serology revealed positive P-ANCA (1:320), myeloperoxidase antibody, proteinase-3 antibody (108.8 U) consistent with pauci-immune P-ANCA Vasculitis. Despite treatment with steroids, cyclophosphamide and plasmapheresis, she deteriorated with hemoptysis, dyspnea and respiratory failure. Chest imaging revealed extensive bilateral infiltrates predominantly at the lung bases consistent with pulmonary hemorrhage. By day 8, hemoptysis resolved, she was extubated, and plasmapheresis was discontinued. A few days later she again decompensated requiring resumption of high dose IV steroid and plasmapheresis. She died despite all measures.