scholarly journals The role of extra-corporeal membrane oxygenation (ECMO) in the treatment of diffuse alveolar haemorrhage secondary to ANCA-associated vasculitis: report of two cases and review of the literature

2018 ◽  
Vol 39 (2) ◽  
pp. 367-375 ◽  
Author(s):  
Paolo Delvino ◽  
Sara Monti ◽  
Silvia Balduzzi ◽  
Mirko Belliato ◽  
Carlomaurizio Montecucco ◽  
...  
Keyword(s):  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Review Of The Literature ◽  
Extra Corporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Anca Associated Vasculitis

scholarly journals Vasculitis and Breast Cancer: Mind the Hint

2021 ◽  
pp. 550-560
Author(s):  
Miguel Esperança-Martins ◽  
Vasco Evangelista ◽  
Salomão Fernandes ◽  
Raquel Almeida
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Small Vessel ◽  
Alveolar Haemorrhage ◽  
Small Vessel Vasculitis ◽  
Diffuse Alveolar Haemorrhage ◽  
Anca Associated Vasculitis ◽  
First Case ◽  
Circulating Antibodies ◽  
Perinuclear Anca

Diffuse alveolar haemorrhage related to an anti-neutrophil cytoplasmic antibody (ANCA)-associated small vessel vasculitis is an extremely rare form of presentation of breast cancer. Here we report the case of a 77-year-old woman with a histological diagnosis of a papillary ductal carcinoma of the breast presenting with a diffuse alveolar haemorrhage secondary to a perinuclear ANCA-associated vasculitis. To our knowledge, this is the first case ever reported of a diffuse alveolar haemorrhage related to an ANCA-associated small vessel vasculitis as a form of presentation of breast cancer. The therapeutic approach of this paraneoplastic vasculitis included the use of corticosteroids and plasmapheresis, a very useful technique to remove endothelial aggressors (circulating antibodies) as a strategy to earn time for a proper therapeutic decision specifically directed for disease modification, but that can also be associated with several severe adverse effects, which are illustrated in our case.

scholarly journals The Role of Extra Corporeal Membrane Oxygenation for Treatment of the Adult Respiratory Distress Syndrome: Review and Quantitative Analysis

2008 ◽  
Vol 36 (2) ◽  
pp. 152-161 ◽  
Author(s):  
R. P. Chalwin ◽  
J. L. Moran ◽  
P. L. Graham
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Adult Respiratory Distress Syndrome ◽  
Randomised Controlled Trials ◽  
Distress Syndrome ◽  
Controlled Trials ◽  
Extra Corporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Randomised Controlled

The role of Extra corporeal membrane oxygenation (ECMO) has not been formally validated for patients with adult respiratory distress syndrome. In anticipation of publication of the conventional ventilation versus ECMO in severe adult respiratory failure (CESAR) trial, the role of ECMO in this setting was reviewed. An electronic search for studies reporting the use of ECMO for the treatment of adult respiratory distress syndrome revealed two randomised controlled trials and three non-controlled trials. Bayesian analysis on the two randomised controlled trials produced an odds ratio mortality of 1.28 (credible interval 0.24 to 6.55) demonstrating no significant harm or benefit. Pooling was not possible for the non-controlled studies because of differing admission status and ECMO selection criteria and an inability to control for these differences in the absence of individual patient data. A large number (n=35) of case series have been published with generally more positive results. We also present a comprehensive narrative commentary on the history, current practice and future for ECMO. ECMO, as rescue therapy for adult respiratory distress syndrome, appears to be an unvalidated rescue treatment option. Analysis and review of trial data does not support its application; however the body of reported cases suggests otherwise. Until the CESAR trial provides an authoritative answer ECMO will continue to be offered on a case by case basis.

Crimean Congo hemorrhagic fever and diffuse alveolar haemorrhage

2008 ◽  
Vol 38 (4) ◽  
pp. 252-254 ◽  
Author(s):  
Levent Doganci ◽  
Meltem Ceyhan ◽  
Nuriye Fisgin Tasdeler ◽  
Hanife Sarikayalar ◽  
Necla Tulek
Keyword(s):  
Hemorrhagic Fever ◽  
Clinical Results ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Haemorrhagic Fever ◽  
Fatal Disease ◽  
Direct Role ◽  
Cchf Virus ◽  
Crimean Congo Haemorrhagic Fever

Although the pathology of Crimean Congo haemorrhagic fever (CCHF) is mainly related to a haemorrhagic process with secondary cytokine storm, there have been no published reports of this fatal disease being a cause of diffuse alveolar haemorrhage (DAH). There are many aetiological factors emphasizing the direct role of endothelial injury on DAH. We present the case of a young adult Turkish man with diffuse bilateral alveolar haemorrhage without an episode of gross haemoptysis caused by the CCHF virus. Successful clinical results and a rapid clinical and radiological clearance were obtained within few days after starting daily oral ribavirin treatment. This fatal infection should be considered to exist in any patient presenting with DAH, and should rapidly be treated with ribavirin. Another very important factor which should always be borne in mind is the contagious character of the CCHF virus. It is one of the most dangerous microorganisms transmitted from person to person. Even the bronchoscopes contaminated with patient blood carry a high risk for nosocomial spread to medical staff and other patients.

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