Acharya Vishak, Shreenivasa A, Adiga Deepa, Mahabala Chakrapani, Shenoy Sajjan, Rai Santosh
Kasturba Medical College, Mangalore,Manipal Academy of Higher Education, Manipal, Karnataka, India.
Respir Med Case Rep. 2020 Jul 2;31:101144. doi: 10.1016/j.rmcr.2020.101144. eCollection 2020.
We report an unusual case of massive haemoptysis in young patient with mass lesion in left upper lobe. Bronchoscopic biopsy, percutaneous CT guided biopsy & serum marker confirmed the lesion to be granulomatous with polyangiitis (GPA). Rarity of the case was endoluminal bronchial lesion in GPA and radiographic presentation of mass lesion on the Computed Tomography. Also this case highlights that massive haemoptysis can be a sole and initial manifestation of GPA. Prompt diagnosis & pulse therapy led to dramatic symptomatic, clinical & radiological improvement, emphasizing the fact that GPA can present as acute emergency and rapid diagnosis with early treatment initiation with pulse steroid therapy & rituximab can be life saving measure.
我们报告了一例年轻患者的罕见大量咯血病例,该患者左上叶有肿块病变。支气管镜活检、经皮CT引导下活检及血清标志物检查确诊该病变为肉芽肿性多血管炎(GPA)。该病例的罕见之处在于GPA中的腔内支气管病变以及计算机断层扫描上肿块病变的影像学表现。此外,该病例还突出表明大量咯血可能是GPA的唯一首发表现。及时诊断和脉冲治疗导致症状、临床及影像学显著改善,强调了GPA可表现为急性急症,早期启动脉冲类固醇治疗和利妥昔单抗进行快速诊断并早期治疗可能是挽救生命的措施。