“When these things are suspected, you need to be called earlier and you need to educate your pulmonary and critical-care colleagues to do so,” Dr. Dellaripa said.
He also touched on the possibility of plasmapheresis in a patient who was ANCA positive and had fallen critically ill.
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Even though plasmapheresis is expensive, “it’s certainly a reasonable consideration, although the data up to now is still not very solid. … You have to decide whether to use that as a bridge [while] waiting for your therapies to work.”
Thomas R. Collins is a freelance medical writer based in Florida.
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References
- Cruz BA, Ramanoelina J, Mahr A, et al. Prognosis and outcome of 26 patients with systemic necrotizing vasculitis admitted to the intensive care unit. Rheumatology (Oxford). 2003 Oct;42(10):1183–1188.
- Siripaltoon B, Lertwises S, Uea-Areewongsa P, et al. A study of Thai patients with systemic lupus erythematosus in the medical intensive care unit: Epidemiology and predictors of mortality. Lupus. 2015 Jan;24(1):98–106.