eISSN: 2084-9869
ISSN: 1233-9687
Polish Journal of Pathology
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SCImago Journal & Country Rank
4/2018
vol. 69
 
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abstract:
Original paper

Various patterns of acute alveolar haemorrhage in patients with microscopic polyangiitis: a clinicopathological study of four cases

Naoto Kuroda, Kenji Yorita, Kei Sakamoto, Kazuya Tsuji

Pol J Pathol 2018; 69 (4): 384-387
Online publish date: 2019/01/31
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It is well known that acute alveolar haemorrhage (AAH) is attributed to capillaritis in most cases with microscopic polyangiitis (MPA). In this article, we explore the cause of alveolar haemorrhage in MPA patients. In the present study, we extracted four autopsy cases of MPA with AAH. Patient’s sex and age, cause of alveolar haemorrhage, therapy, follow-up duration, and cause of death were investigated. As a result, alveolar haemorrhage was caused by diffuse alveolar damage (DAD) due to candidiasis or influenza virus infection, haemorrhagic infarct due to aspergillosis, capillaritis due to MPA, vasculitis due to cytomegalovirus (CMV), and herpes simplex virus (HSV) infection. All patients received corticosteroid therapy, and one patient additionally underwent administration of cyclophosphamide. The duration of follow-up ranged from one to 26 months with a mean of eight months. All patients died of respiratory failure. In summary, clinicians and pathologists should recognise some causes of alveolar haemorrhage in MPA patients, which include DAD, haemorrhagic infarct, virus-associated vasculitis, or MPA-associated capillaritis.
keywords:

alveolar haemorrhage, microscopic polyangiitis

references:
Wilke L, Prince-Fiocco M, Fiocco GP. Microscopic polyangiitis. A large single-center series. J Clin Rheumatol 2014; 20: 179-182.
Pesci A, Manganelli P. Respiratory system involvement in antineutrophil cytoplasmic-associated systemic vasculitis. Drugs 2007; 8: 26-42.
Martinez-Martinez MU, Herrera-van Oostdam DA, Abud-
Mendoza C. Diffuse alveolar hemorrhage in autoimmune diseases. Curr Rheumatol Rep 2017; 19: 27.
Lara AR, Schwarz MI. Diffuse alveolar hemorrhange. Chest 2010; 137: 1164-1171.
Cardinal-Fernandez P, Lorente JA, Ballen-Barragan A, et al. Acute repiratory distress syndrome and diffuse alveolar damage new insights on a complex relationship. Ann Am Thorac Soc 2017; 14: 844-850.
Isono M, Araki H, Haitani T, et al. Diffuse alveolar hemorrhage in lupus nephritis complicated by microscopic polyangiitis. Clin Exp Nephrol 2011; 15: 294-298.
Yoshida M. Strategy of infection control in immunosuppressive therapy for ANCA-associated vasculitis. Ann Vasc Dis 2013; 6: 9-15.
Takizawa Y, Inokuma S, Tanaka Y, et al. Clinical characteristics of cytomegalovirus infection in rheumatic diseases: multicentre survey in a large patient population. Rheumatology (Oxford) 2008; 47: 1373-1378.
Meyer MF, Hellmich B, Kotterba S, et al. Cytomegalovirus infection in systemic necrotizing vasculitis: causative agent or opportunistic infection? Rheumatol Int 2000; 20: 35-38.
Kimoto Y, Orryoji K, Uchino A, et al. Peuritis clinically diagnosed as aspergillosis during the course of microscopic polyangiitis. Intern Med 2014; 53: 2821-2824.
Miyoshi I, Daibata M, Taguchi H, et al. Viral pneumonia: coinfection of cytomemegalovirus and herpes simplex virus. Intern Med 2005; 44: 518-519.
Engelmann I, Hesse N, Fegbeutel C, et al. Incidence and impact of herpes simplex and cytomegalovirus detection in the respiratory tract after lung transplantation. Transpl Infect Dis 2011; 13: 259-265.
Nagarakanti S, Bishburg E, Bapat A. Adenovirus, herpes simplex virus and cytomegalovirus infection in a lung transplant recipient. IDCases 2018; 11: 91-93.
Ward ND, Cosner DE, Lamb CA, et al. To differential diagnosis should be microscopic polyangiitis in ANCA-positive patient with diffuse pulmonary hemorrhage and hemosiderosis. Case Reports in Pathology 2014; 2014: 286030.
Lababidi MH, Odigwe C, Okolo C, et al. Microscopic polyangiitis causing diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis. Proc (Bayl Univ Med Cent) 2015; 28: 469-471.
Tashiro H, Takahashi K, Sadamatsu H, et al. Chronic and asymptomatic diffuse alveolar haemorrhage with microscopic polyangiitis: A case report and review of the literature. Case Reports in Rheumatology 2016; 2016: 165126.
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