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Hemoptysis in a Young Indian Male
A 22-year-old Indian male presented to the emergency department with hemoptysis. A month prior, he had presented to an urgent care center complaining of cough with occasional episodes of blood-tinged sputum in the morning. He was diagnosed with community-acquired pneumonia based on a chest X-ray without laboratory testing and was prescribed levofloxacin. A few days…
Diffuse Alveolar Hemorrhage Secondary to Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: Predictors of Respiratory Failure and Clinical Outcomes
A variety of immune and nonimmune pathophysiologic mechanisms causing the disruption of alveolar capillaries with bleeding into the alveolar spaces can lead to diffuse alveolar hemorrhage (DAH). Immune-mediated mechanisms can cause DAH with or without the presence of capillaritis. The antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) syndromes—granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA)—are the…
Catastrophic Antiphospholipid Syndrome with Pulmonary Hemorrhage: A Case Report
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by hypercoagulability often manifested as recurrent thrombosis or pregnancy complications, with persistently circulating antiphospholipid (aPL) antibodies or lupus anticoagulant. Catastrophic APS (CAPS), also known as Asherson syndrome, occurs in less than 1% of cases of APS and involves occlusive microangiopathy in at least three organ systems.1 Case…
Case Report: Hydralazine-Induced ANCA-Associated Vasculitis
Hydralazine has been in use as a treatment for hypertension, most notably in heart failure patients, since 1951.1 The drug is a known cause of autoimmune disease, most specifically hydralazine-induced lupus. Hydralazine-induced lupus occurs in 7–13% of those taking the medication.2-4 It often presents with constitutional symptoms, arthritis/arthralgias, cutaneous lesions, serositis, myalgias and/or hepatomegaly. Features…