Kim Jong Ha, Park Sin-Youl
Department of Emergency Medicine, Kyungpook National University Chilgok-Hospital, Daegu, Korea.
Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Yeungnam Univ J Med. 2020 Jan;37(1):59-62. doi: 10.12701/yujm.2019.00304. Epub 2019 Sep 4.
Hemoptysis is a major reason for emergency department (ED) visits. Catamenial hemoptysis (CH), a rare condition of thoracic endometriosis, can cause recurrent hemoptysis but is difficult to diagnose in the ED due to the scarcity of cases and nonspecific clinical findings. We report a case of a 26-year-old woman who presented to the ED with recurrent hemoptysis since 2 years without a definite cause. Her vital signs and blood test findings were unremarkable. Chest computed tomography (CT) did not show any specific lesions other than a non-specific ground-glass opacity pattern in her right lung. She was on day 4 of her menstrual cycle and her hemoptysis frequently occurred during menstruation. Although there was no histological confirmation, based on her history of hemoptysis during menstruation and no other cause of the hemoptysis, the patient was tentatively diagnosed with CH and was administered gonadotropin-releasing hormone. She had no recurrence of hemoptysis for 3 months. While CH is difficult to diagnose in the ED, the patient's recurrent hemoptysis related to menstruation was a clue to the presence of CH. Therefore, physicians should determine the relationship between hemoptysis and menstruation for women of childbearing age presenting with repeated hemoptysis without a definite cause.
咯血是急诊科就诊的主要原因。经期咯血（CH）是一种罕见的胸段子宫内膜异位症，可导致反复咯血，但由于病例稀少且临床症状不具特异性，在急诊科很难诊断。我们报告一例26岁女性病例，该患者自2年前起反复出现咯血，病因不明。她的生命体征和血液检查结果均无异常。胸部计算机断层扫描（CT）除右肺出现非特异性磨玻璃影外，未显示任何特异性病变。她处于月经周期的第4天，咯血频繁发生在月经期。尽管没有组织学确诊依据，但根据她月经期咯血的病史以及咯血无其他病因，该患者被初步诊断为CH，并给予促性腺激素释放激素治疗。她3个月内未再出现咯血。虽然CH在急诊科难以诊断，但患者与月经相关的反复咯血是存在CH的线索。因此，对于反复咯血且病因不明的育龄期女性，医生应确定咯血与月经之间的关系。
