Open AccessWegener's Granulomatosis Associated with Diffuse Pulmonary Hemorrhage
Author(s) -
Yoshimum Nobuyuki,
Matsubam Osamu,
Tamura Atsuhisa,
Kasuga Tsutomu,
Mark Eugene J.
Publication year - 1992
Publication title -
acta patholigica japonica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
ISSN - 0001-6632
DOI - 10.1111/j.1440-1827.1992.tb03047.x
Subject(s) - diffuse alveolar hemorrhage , medicine , pathology , prednisolone , pulmonary hemorrhage , necrotizing vasculitis , sputum , bloody , lung , vasculitis , diffuse alveolar damage , surgery , tuberculosis , disease , acute respiratory distress
The authors report a case of Wegner's granulomatosis with the unusual manifestation of diffuse pulmonary hemorrhage. A 58‐year‐old man complained of bloody sputum and fever. Chest X‐ray films showed multiple nodular shadows in both lung fields. He was diagnosed as having Wegener's granulomatosis by transbronchial lung biopsy, which revealed necrotizing granulomatous inflammation with necrotizing vasculitis. Despite treatment with cyclo‐phosphamide and prednisolone, his condition rapidly deteriorated. An extensive diffuse alveolar shadow appeared in both lung fields in chest X‐ray films, anemia became worse, and he died of respiratory failure. Autopsy revealed diffuse alveolar hemorrhage with necrotizing capillaritis in addition to the typical pathological findings in Wegener's granulomatosis. The capillaritis was characterized by neutrophilic infiltration of alveolar septa, and fibrin thrombi in alveolar capillaries. Diffuse pulmonary hemorrhage is uncommon in Wegener's granulomatosis. However, once diffuse pulmonary hemorrhage occurs, the respiratory condition rapidly deteriorates and is life‐threatening. Therefore, accurate diagnosis and appropriate treatment are required. Acta Pathol Jpn 42: 657–661, 1992.