Granulomatosis with polyangiitis presenting with diffuse alveolar hemorrhage requiring extracorporeal membrane oxygenation with rapid multiorgan relapse: A case report

Jennifer Vanoli, Marta Riva, Beatrice Vergnano, Gabriele D'Andrea, Vincenzo L'Imperio, Maria Rosa Pozzi, Guido Grassi

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale: Granulomatosis with polyangiitis (GPA) is an antineutrophil cytoplasmatic antibodies (ANCA)-associated vasculitis affecting small- and medium-sized blood vessels, mostly involving lung and kidney. Patient concerns: We report the case of a 33-year-old man that presented with acute respiratory distress syndrome caused by alveolar hemorrhage. Diagnoses: Aggressive GPA presenting with diffuse alveolar hemorrhage and multiorgan involvement. Inteventions: Immunosuppressive therapy, plasma exchange, extracorporeal membrane oxygenation (ECMO). Outcomes: Relapse occurred very early, despite immunosuppressive treatment, with a rare involvement of genital system (epididymitis) and rapidly progressive glomerulonephritis difficult to treat. Lessons: GPA is a challenging, multifaceted disease that can require aggressive supportive therapy and is associated with a high rate of relapse that may present with uncommon site of involvement.

Original languageEnglish
Article numbere6024
JournalMedicine (United States)
Volume96
Issue number13
DOIs
Publication statusPublished - Jan 1 2017

Keywords

  • Case report
  • Diffuse alveolar hemorrhage
  • Extracorporeal membrane oxygenation
  • Granulomatosis with polyangiitis

ASJC Scopus subject areas

  • Medicine(all)

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