An unusual case of hemoptysis – Updates from morning report (6/19/19)

At this week’s morning report (6/20/19) we discussed a very interesting case of hemoptysis. This patient presented with large volume hemoptysis and respiratory distress, and was found to have the below chest x-ray.

Unilateral DAH CXR In addition to unilateral(diffuse?) alveolar hemorrhage, the patient had acute and progressive renal dysfunction. Although unilateral alveolar hemorrhage is quite unusual, this combination of hemoptysis and glomerulonephritis is typical of pulmonary-renal syndrome. With further work-up the patient was found to be ANCA and PR3 antibody positive (consistent with a diagnosis of GPA). The following case series of  Unilateral Alveolar Hemorrhage found that most cases of right-sided alveolar hemorrhage where associated with cardiac conditions (unlike the case we discussed).

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