Diffuse alveolar hemorrhage, a rare presentation of polymyositis

Abstract

Background 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 ]. Case presentation 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. Conclusion This case of diffuse alveolar hemorrhage was most likely due to polymyositis.

Successful rituximab therapy in adult-onset IgA vasculitis with diffuse alveolar hemorrhage and renal failure: a case report

“…Formal diagnosis of DAH requires bronchoscopy with serial BAL demonstrating either ( 4 ) progressively more hemorrhagic lavage fluid with each instillation and/or ( 5 ) hemosiderin laden macrophages on cytology ( 8 ). The phenotype of DAH encompasses a number of distinct immune and non-immune pathologic entities including pulmonary capillaritis, bland pulmonary hemorrhage, and diffuse alveolar damage ( 9 ). Of these etiologies, pulmonary capillaritis is the most common, responds to immunosuppression ( 10 ), and is generally associated with systemic vasculitides and connective tissue disorders ( 11 ).…”

Prone Positioning May Improve the Treatment of Diffuse Alveolar Hemorrhage and Severe Acute Respiratory Distress Syndrome (ARDS) Secondary to ANCA Associated Vasculitis: A Case Report

“…ARDS, a life-threatening condition, causes severe mortality that varies from 34.9% for mild ARDS to 46.1% for severe ARDS, even with mechanical ventilation or even ECMO support [1]. DAH, a rare cause of ARDS, presents with hemoptysis resulting from intra-alveolar RBC accumulation and may hinder alveolar oxygenation and progress to hypoxia [2]. Here, we report a case of a 74-year-old male who was diagnosed with DAH-related ARDS treated successfully with prone positioning.…”