Recurrent Episodes of Diffuse Alveolar Hemorrhage in Systemic Sclerosis 30 Days Apart
Identifieur interne : 000479 ( Main/Exploration ); précédent : 000478; suivant : 000480Recurrent Episodes of Diffuse Alveolar Hemorrhage in Systemic Sclerosis 30 Days Apart
Auteurs : Hussien Saab [États-Unis] ; Tushar Bajaj [États-Unis] ; Kirandeep Bains [États-Unis] ; Ralph Garcia-Pacheco [États-Unis]Source :
- Journal of Investigative Medicine High Impact Case Reports [ 2324-7096 ] ; 2019.
Abstract
Diffuse alveolar hemorrhage (DAH) is a life-threatening clinicopathologic condition caused by accumulation of intra-alveolar red blood cells (RBCs) after disruption of the alveolar-capillary basement membrane that is often seen as a complication of various diseases, but is rare in systemic sclerosis. A 46-year-old female with systemic sclerosis presented to the emergency department complaining of right-sided chest pain. Initially, her electrocardiogram and chest X-ray (CXR) were unremarkable; however, she progressively decompensated into acute respiratory failure resulting in intubation. Repeat CXR and computed tomography scan showed diffuse bilateral alveolar infiltrates and pleural effusions. Video bronchoscopy with bronchoalveolar lavage showed numerous RBCs, neutrophils, macrophages, and respiratory epithelial cells consistent with acute DAH. She was started on intravenous pulse-dosing Solu-Medrol 1 g daily for 5 days. One month later, the patient returned with intractable nausea and vomiting. Again, she went into acute respiratory distress with a PaO2 of 59 while on a 10-L non-rebreather mask. CXR revealed development of alveolar infiltrates in the right lung. A bronchoscopy with bronchoalveolar lavage again showed numerous RBCs and neutrophils along with staining positive for hemosiderin-laden macrophages. Systemic sclerosis with alveolar hemorrhage is a rare occurrence; however, most cases are single episodes of hemorrhage, whereas we present a case with 2 confirmed episodes within 30 days. Its life-threatening nature makes a systemic approach and aggressive treatment crucial to decreasing morbidity and mortality—making it a diagnosis that should not be overlooked, especially in patients with nonspecific symptoms.
Url:
DOI: 10.1177/2324709619846594
PubMed: 31053041
PubMed Central: 6505231
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 000305
- to stream Pmc, to step Curation: 000305
- to stream Pmc, to step Checkpoint: 000435
- to stream Ncbi, to step Merge: 000589
- to stream Ncbi, to step Curation: 000589
- to stream Ncbi, to step Checkpoint: 000589
- to stream Main, to step Merge: 000479
- to stream Main, to step Curation: 000479
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Recurrent Episodes of Diffuse Alveolar Hemorrhage in Systemic Sclerosis 30 Days Apart</title>
<author><name sortKey="Saab, Hussien" sort="Saab, Hussien" uniqKey="Saab H" first="Hussien" last="Saab">Hussien Saab</name>
<affiliation wicri:level="1"><nlm:aff id="aff1-2324709619846594">UCLA-Kern Medical, Bakersfield, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UCLA-Kern Medical, Bakersfield, CA</wicri:regionArea>
<wicri:noRegion>CA</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bajaj, Tushar" sort="Bajaj, Tushar" uniqKey="Bajaj T" first="Tushar" last="Bajaj">Tushar Bajaj</name>
<affiliation wicri:level="1"><nlm:aff id="aff1-2324709619846594">UCLA-Kern Medical, Bakersfield, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UCLA-Kern Medical, Bakersfield, CA</wicri:regionArea>
<wicri:noRegion>CA</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bains, Kirandeep" sort="Bains, Kirandeep" uniqKey="Bains K" first="Kirandeep" last="Bains">Kirandeep Bains</name>
<affiliation wicri:level="1"><nlm:aff id="aff2-2324709619846594">Ross University School of Medicine, Miramar, FL, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Ross University School of Medicine, Miramar, FL</wicri:regionArea>
<wicri:noRegion>FL</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Garcia Pacheco, Ralph" sort="Garcia Pacheco, Ralph" uniqKey="Garcia Pacheco R" first="Ralph" last="Garcia-Pacheco">Ralph Garcia-Pacheco</name>
<affiliation wicri:level="1"><nlm:aff id="aff1-2324709619846594">UCLA-Kern Medical, Bakersfield, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UCLA-Kern Medical, Bakersfield, CA</wicri:regionArea>
<wicri:noRegion>CA</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">31053041</idno>
<idno type="pmc">6505231</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505231</idno>
<idno type="RBID">PMC:6505231</idno>
<idno type="doi">10.1177/2324709619846594</idno>
<date when="2019">2019</date>
<idno type="wicri:Area/Pmc/Corpus">000305</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000305</idno>
<idno type="wicri:Area/Pmc/Curation">000305</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000305</idno>
<idno type="wicri:Area/Pmc/Checkpoint">000435</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000435</idno>
<idno type="wicri:Area/Ncbi/Merge">000589</idno>
<idno type="wicri:Area/Ncbi/Curation">000589</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">000589</idno>
<idno type="wicri:Area/Main/Merge">000479</idno>
<idno type="wicri:Area/Main/Curation">000479</idno>
<idno type="wicri:Area/Main/Exploration">000479</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Recurrent Episodes of Diffuse Alveolar Hemorrhage in Systemic Sclerosis 30 Days Apart</title>
<author><name sortKey="Saab, Hussien" sort="Saab, Hussien" uniqKey="Saab H" first="Hussien" last="Saab">Hussien Saab</name>
<affiliation wicri:level="1"><nlm:aff id="aff1-2324709619846594">UCLA-Kern Medical, Bakersfield, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UCLA-Kern Medical, Bakersfield, CA</wicri:regionArea>
<wicri:noRegion>CA</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bajaj, Tushar" sort="Bajaj, Tushar" uniqKey="Bajaj T" first="Tushar" last="Bajaj">Tushar Bajaj</name>
<affiliation wicri:level="1"><nlm:aff id="aff1-2324709619846594">UCLA-Kern Medical, Bakersfield, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UCLA-Kern Medical, Bakersfield, CA</wicri:regionArea>
<wicri:noRegion>CA</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bains, Kirandeep" sort="Bains, Kirandeep" uniqKey="Bains K" first="Kirandeep" last="Bains">Kirandeep Bains</name>
<affiliation wicri:level="1"><nlm:aff id="aff2-2324709619846594">Ross University School of Medicine, Miramar, FL, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Ross University School of Medicine, Miramar, FL</wicri:regionArea>
<wicri:noRegion>FL</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Garcia Pacheco, Ralph" sort="Garcia Pacheco, Ralph" uniqKey="Garcia Pacheco R" first="Ralph" last="Garcia-Pacheco">Ralph Garcia-Pacheco</name>
<affiliation wicri:level="1"><nlm:aff id="aff1-2324709619846594">UCLA-Kern Medical, Bakersfield, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UCLA-Kern Medical, Bakersfield, CA</wicri:regionArea>
<wicri:noRegion>CA</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of Investigative Medicine High Impact Case Reports</title>
<idno type="eISSN">2324-7096</idno>
<imprint><date when="2019">2019</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Diffuse alveolar hemorrhage (DAH) is a life-threatening clinicopathologic condition caused by accumulation of intra-alveolar red blood cells (RBCs) after disruption of the alveolar-capillary basement membrane that is often seen as a complication of various diseases, but is rare in systemic sclerosis. A 46-year-old female with systemic sclerosis presented to the emergency department complaining of right-sided chest pain. Initially, her electrocardiogram and chest X-ray (CXR) were unremarkable; however, she progressively decompensated into acute respiratory failure resulting in intubation. Repeat CXR and computed tomography scan showed diffuse bilateral alveolar infiltrates and pleural effusions. Video bronchoscopy with bronchoalveolar lavage showed numerous RBCs, neutrophils, macrophages, and respiratory epithelial cells consistent with acute DAH. She was started on intravenous pulse-dosing Solu-Medrol 1 g daily for 5 days. One month later, the patient returned with intractable nausea and vomiting. Again, she went into acute respiratory distress with a PaO<sub>2</sub>
of 59 while on a 10-L non-rebreather mask. CXR revealed development of alveolar infiltrates in the right lung. A bronchoscopy with bronchoalveolar lavage again showed numerous RBCs and neutrophils along with staining positive for hemosiderin-laden macrophages. Systemic sclerosis with alveolar hemorrhage is a rare occurrence; however, most cases are single episodes of hemorrhage, whereas we present a case with 2 confirmed episodes within 30 days. Its life-threatening nature makes a systemic approach and aggressive treatment crucial to decreasing morbidity and mortality—making it a diagnosis that should not be overlooked, especially in patients with nonspecific symptoms.</p>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Park, Ms" uniqKey="Park M">MS. Park</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lara, Ar" uniqKey="Lara A">AR Lara</name>
</author>
<author><name sortKey="Schwarz, Mi" uniqKey="Schwarz M">MI. Schwarz</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="G Mez Roman, Jj" uniqKey="G Mez Roman J">JJ. Gómez-Román</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Santos Ocampo, S" uniqKey="Santos Ocampo S">S Santos-Ocampo</name>
</author>
<author><name sortKey="Mandell, Bf" uniqKey="Mandell B">BF Mandell</name>
</author>
<author><name sortKey="Fessler, Bj" uniqKey="Fessler B">BJ. Fessler</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
</list>
<tree><country name="États-Unis"><noRegion><name sortKey="Saab, Hussien" sort="Saab, Hussien" uniqKey="Saab H" first="Hussien" last="Saab">Hussien Saab</name>
</noRegion>
<name sortKey="Bains, Kirandeep" sort="Bains, Kirandeep" uniqKey="Bains K" first="Kirandeep" last="Bains">Kirandeep Bains</name>
<name sortKey="Bajaj, Tushar" sort="Bajaj, Tushar" uniqKey="Bajaj T" first="Tushar" last="Bajaj">Tushar Bajaj</name>
<name sortKey="Garcia Pacheco, Ralph" sort="Garcia Pacheco, Ralph" uniqKey="Garcia Pacheco R" first="Ralph" last="Garcia-Pacheco">Ralph Garcia-Pacheco</name>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/ChloroquineV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000479 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000479 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Sante |area= ChloroquineV1 |flux= Main |étape= Exploration |type= RBID |clé= PMC:6505231 |texte= Recurrent Episodes of Diffuse Alveolar Hemorrhage in Systemic Sclerosis 30 Days Apart }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:31053041" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \ | NlmPubMed2Wicri -a ChloroquineV1
This area was generated with Dilib version V0.6.33. |