Samuel Sharoon, Brown Brent, Mason Nita, Abdo Tony
Department of Internal Medicine, University of South Dakota Sanford School of Medicine, USA.
Department of Pulmonary & Critical Care, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA.
Respir Med Case Rep. 2020 Oct 17;31:101261. doi: 10.1016/j.rmcr.2020.101261. eCollection 2020.
Diffuse alveolar hemorrhage is a medical emergency caused by persistent and recurrent pulmonary hemorrhage [1]. It is an uncommon presentation of polymyositis. Symptoms of polymyositis include fatigue, muscle pains, proximal muscle weakness, and joint pains [2].
A 44-year-old male presented with new onset shortness of breath and productive cough with white sputum and occasional hemoptysis. The patient was diagnosed with diffuse alveolar hemorrhage (DAH) via bronchoscopy and discharged initially on prednisone. The patient's laboratory work indicated positive titers of ANA & anti-Jo-1 antibody with low complement levels. These results pointed towards the diagnosis of polymyositis [3]. DAH can also be caused by systemic lupus erythematosus, Goodpasture's syndrome, Sjogren syndrome, anticoagulant therapy, and antiphospholipid antibody syndrome [4]. However, the possibility of these potential causes was excluded.
This case of diffuse alveolar hemorrhage was most likely due to polymyositis.
弥漫性肺泡出血是一种由持续性和复发性肺出血引起的医疗急症[1]。它是多发性肌炎的一种不常见表现。多发性肌炎的症状包括疲劳、肌肉疼痛、近端肌无力和关节疼痛[2]。
一名44岁男性出现新发气短、伴有白色痰液的咳痰和偶尔咯血。该患者通过支气管镜检查被诊断为弥漫性肺泡出血（DAH），最初出院时服用泼尼松。患者的实验室检查显示ANA和抗Jo - 1抗体滴度阳性，补体水平低。这些结果指向多发性肌炎的诊断[3]。弥漫性肺泡出血也可由系统性红斑狼疮、古德帕斯丘综合征、干燥综合征、抗凝治疗和抗磷脂抗体综合征引起[4]。然而，排除了这些潜在病因的可能性。
该例弥漫性肺泡出血最可能是由多发性肌炎所致。
