Diffuse alveolar hemorrhage as a life‑ threatening manifestation of newly diagnosed granulomatosis with polyangiitis following COVID-19 infection – a case report

Česká verzia

Authors: Pavlína Kostelníková ¹; Martina Skácelová ¹; Martin Špíšek ²; Miroslav Šimíček ³; Pavel Horák ¹
Authors place of work: III. interní klinika – nefrologická, revmatologická a endokrinologická, FN Olomouc a LF UP Olomouc ¹; Interní oddělení, Nemocnice AGEL Valašské Meziříčí, a. s. ²; Plicní ambulance, Nemocnice AGEL Valašské Meziříčí, a. s. ³
Published in the journal: Vnitř Lék 2022; 68(5): 290-294
Category: Main Topic
doi: https://doi.org/10.36290/vnl.2022.062

Summary

A case report of a patient with newly diagnosed granulomatosis with polyangiitis (GPA) after undergoing COVID-19 (Coronavirus Disease 2019) is discussed. GPA is one of the ANCA-associated vasculitis, which is characterized by the presence of autoantibodies against cytoplasmic enzymes neutrophils (Anti Neutrophil Cytoplasmatic Antibodies). It is a vasculitis that mainly affects small blood vessels, leading to damage to the kidneys, lungs, and upper respiratory tract, including the paranasal sinuses and orbits. This disease can result in an acute life-threatening condition. Such complications include diffuse alveolar hemorrhage (DAH), a condition characterized by blood leakage from the pulmonary vessels into the alveoli, often leading to acute vital signs and even respiratory failure. DAH can have many causes – autoimmune diseases including vasculitides as well as non-immunological causes. Early and adequate comprehensive therapy including immunosuppressive treatment (cyclophosphamide/rituximab and glucocorticoids) can be life-saving.

Keywords:

plasmapheresis – Cyclophosphamide – granulomatosis with polyangiitis – diffuse alveolar hemorrhage

Zdroje

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