Open AccessP-ANCA vasculitis with diffuse alveolar haemorrhage preceded by a spider bite
Author(s) -
Ali Hameed Ali,
Mandip Kang,
Jaafar Aldahwi,
Candice Reyes
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-233710
Subject(s) - medicine , diffuse alveolar hemorrhage , vasculitis , rash , dermatology , rituximab , methylprednisolone , respiratory failure , diffuse alveolar damage , surgery , pathology , lung , disease , acute respiratory distress , lymphoma
We report a patient with antineutrophilic cytoplasmic antibody (ANCA) vasculitis that was preceded by witnessed black widow spider bites. The patient initially presented with a diffuse painful skin rash that developed after a few hours post bite. He was treated initially with topical ointment for the suspected bite. However, subsequently a few days later the patient returned to the hospital with similar, but more progressive rash with haemoptysis and acute hypoxic respiratory failure requiring supplemental oxygen. Immunology work up showed elevated titre of peri-nuclear ANCA. Bronchoscopy revealed diffuse alveolar haemorrhage. The patient was treated successfully with methylprednisolone and rituximab.