Abstract:
A 76-year-old man with bronchial asthma was admitted for respiratory failure and bloody sputum. A significant drop in haemoglobin and multiple consolidations supported clinical diagnosis of diffuse alveolar haemorrhage (AH). Myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) was positive and urinalysis suggested glomerulonephritis. Based on eosinophilia, sinusitis, peripheral nerve involvement, and leukocytoclastic vasculitis, he was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA) associated with AH. Our case-based review suggested that male predominance (65%), high positivity for ANCA (88%), and a high frequency of renal involvement (45%) may be characteristic of AH in EGPA. Although AH is rare in EGPA, we should be aware of this life-threatening complication.
摘要:
一名患有支气管哮喘的76岁男子因呼吸衰竭和血痰而入院。血红蛋白的显着下降和多次合并支持弥漫性肺泡出血(AH)的临床诊断。髓过氧化物酶-抗中性粒细胞胞浆抗体(MPO-ANCA)阳性,尿液分析提示肾小球肾炎。基于嗜酸性粒细胞增多,鼻窦炎,周围神经受累,白细胞碎裂性血管炎,他被诊断为嗜酸性肉芽肿伴AH相关的多血管炎(EGPA)。我们基于案例的审查表明,男性占主导地位(65%),ANCA的高阳性(88%)和肾脏受累的高频率(45%)可能是EGPA中AH的特征.虽然AH在EGPA很少见,我们应该意识到这种危及生命的并发症。