scholarly journals Fulminant granulomatosis with polyangiitis presenting with diffuse alveolar haemorrhage following COVID-19

2021 ◽  
Vol 14 (6) ◽  
pp. e242628
Author(s):  
Eric Lind ◽  
Andrew Jameson ◽  
Esaw Kurban
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Lung Imaging ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Connective Tissue Disorders ◽  
Diagnostic Challenge ◽  
Local Hospital ◽  
Clinical Presentations ◽  
Similar Appearance ◽  
High Index Of Suspicion

A 40-year-old man developed granulomatosis with polyangiitis (GPA) following a mild case of COVID-19. Initially, he experienced mild migrating joint pain for 2 months prior to testing positive for SARS-CoV-2 but dramatically worsened following resolution of his infection. The pain continued to progress until he suddenly develope haemoptysis, prompting him to present to a local hospital. The diagnosis of diffuse alveolar haemorrhage secondary to GPA was confirmed with labs, imaging and histopathology. Precipitous deterioration of GPA with concurrent COVID-19 infection indicates a possible temporal relationship. Since the onset of the pandemic, SARS-CoV-2 has been anecdotally associated with the development of various connective tissue disorders. The overlapping clinical presentations and similar appearance on lung imaging present clinicians with a diagnostic challenge. This underscores the importance of having a high index of suspicion of autoimmune diagnoses in patients who present with new or worsening findings following a COVID-19 infection.

scholarly journals O6 Diffuse alveolar haemorrhage in connective tissue disorders

2008 ◽  
Vol 3 (3) ◽  
pp. S19
Author(s):  
V Marwaha ◽  
D Mahapatra ◽  
RSV Kumar ◽  
SK Virmani ◽  
VSM
Keyword(s):  
Connective Tissue ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Connective Tissue Disorders

scholarly journals Two cases of extrapulmonary onset granulomatosis with polyangiitis which caused diffuse alveolar haemorrhage

2014 ◽  
Vol 13 ◽  
pp. 32-36 ◽  
Author(s):  
Halide Kaya ◽  
Sureyya Yilmaz ◽  
Cengizhan Sezgi ◽  
Ozlem Abakay ◽  
Mahsuk Taylan ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage

scholarly journals Case of Metastatic Malignant Melanoma Simulating Granuloma Annulare

2021 ◽  
Vol 5 (3) ◽  
pp. 289-292
Author(s):  
Haley Danielle Heibel ◽  
Parneet Dhaliwal ◽  
Etan Marks ◽  
Clay J. Cockerell
Keyword(s):  
Malignant Melanoma ◽  
Metastatic Melanoma ◽  
Immunohistochemical Staining ◽  
Previous History ◽  
Metastatic Malignant Melanoma ◽  
Granuloma Annulare ◽  
Diagnostic Challenge ◽  
Clinical Presentations ◽  
History Of ◽  
High Index Of Suspicion

Malignant melanoma and particularly metastatic melanoma represent a diagnostic challenge due to the wide variety of histologic patterns, resemblance to benign entities, and extensive range of clinical presentations.  A high index of suspicion for melanoma is important for accurate diagnosis, especially when there is a previous history of malignancy.  Here, we present a patient with a history of melanoma and locally metastatic melanoma, who subsequently developed a nodule on his right forearm near the site of his previous melanoma excision.  Histologically, the melanoma appeared as granuloma annulare (GA) with benign cytologic features, but was identified as metastatic melanoma using SOX-10 immunohistochemical staining.  Other malignancies, including lymphomas, leukemias, sarcomas, and cutaneous metastases of internal malignancies, have mimicked GA and interstitial granulomatous processes.  Therefore, further immunohistochemical staining should be performed to assess for metastatic disease in the setting of a histological pattern that resembles a benign granulomatous process in a patient with a history of malignancy, including malignant melanoma.

Haemoptysis following shallow breath-hold diving in a cannabis user

2020 ◽  
Vol 13 (6) ◽  
pp. e234921
Author(s):  
Janice Borg ◽  
Julian Cassar ◽  
Sarah Bonello ◽  
Peter Fsadni
Keyword(s):  
Lower Lobe ◽  
Lung Damage ◽  
Alveolar Haemorrhage ◽  
Cannabis User ◽  
Breath Hold ◽  
Diffuse Alveolar Haemorrhage ◽  
First Case ◽  
History Of ◽  
High Index Of Suspicion ◽  
Parenchymal Damage

We report the first case of a healthy 24-year-old male with a 6-year history of regular cannabis use, who presented with haemoptysis after a shallow 3 m breath-hold dive. Blood investigations showed mild neutrophilia. CT thorax revealed focal ground-glass changes in the superior segment of the lower lobe. With a suspicion of pneumonia, oral antibiotics were initiated to poor effect. Through bronchoscopic visualisation and lavage, a diagnosis of diffuse alveolar haemorrhage was established. The clinical course was benign with resolution of symptoms and changes on CT thorax within 6 weeks of stopping marijuana use. Since all other causes of haemoptysis were excluded, pathophysiology was attributed to cannabis-induced lung parenchymal damage, exacerbated by a shallow breath-hold dive. To ensure appropriate management, a clinician should therefore have a high index of suspicion for drug use and other factors known to cause chronic lung damage in whom other causes of diffuse alveolar haemorrhage are excluded.

scholarly journals Relapsing Polychondritis: An Otolaryngologist's Perspective

2017 ◽  
Vol 9 (1) ◽  
pp. 17-20
Author(s):  
P Naina ◽  
Sheeja S John ◽  
Kamran A Syed
Keyword(s):  
Autoimmune Disease ◽  
Early Diagnosis ◽  
Clinical Condition ◽  
Clinical Signs ◽  
Relapsing Polychondritis ◽  
Diagnostic Challenge ◽  
Diagnosis And Management ◽  
Clinical Presentations ◽  
High Index Of Suspicion ◽  
Nose And Throat

ABSTRACT Relapsing polychondritis (RP) is an uncommon autoimmune disease with varying clinical presentations. Relapsing polychondritis frequently involves the ear, nose, and throat cartilages, often causing subtle and episodic symptoms that can pose a diagnostic challenge to the otolaryngologist. A high index of suspicion is needed to identify these subtle signs leading to early diagnosis. Here, we report a case of RP presenting with hoarseness of voice; we reviewed the literature and clinical signs discussed from an otolaryngologist's perspective. Greater awareness about its episodic and myriad presentation is needed for early diagnosis and management of this uncommon clinical condition. How to cite this article Syed KA, Naina P, John SS, Varghese AM. Relapsing Polychondritis: An Otolaryngologist's Perspective. Int J Otorhinolaryngol Clin 2017;9(1):17-20.

An Uncommon Cause of Diffuse Alveolar Haemorrhage

Respiration ◽  
2007 ◽  
Vol 75 (4) ◽  
pp. 469-471 ◽  
Author(s):  
B. Gartner ◽  
L. Jacquier ◽  
P.A. Petignat ◽  
T. Rochat
Keyword(s):  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage

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.

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