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.
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).