Top

Published in:

Open Access 01-12-2023 | Hemoptysis | Case Report

Massive, life-threatening hemoptysis due to localized granulomatosis with polyangiitis

Authors: Eleonora Coviello, Francesco Puma, Domenico Pourmolkara, Martina Mandarano, Antonio Giulio Napolitano

Published in: Journal of Cardiothoracic Surgery | Issue 1/2023

Abstract

Massive hemoptysis may be related to a wide spectrum of diseases whose differential diagnosis can be challenging, also due to the medical emergency condition.

We present a case of a 33-year-old woman presented to our department with sudden, life-threatening hemoptysis from unknown etiology, which required a rescue pulmonary lobectomy after resuscitation maneuvers. Histology proved to be a localized Wegener granulomatosis. Our case shows that granulomatosis should always be considered among the possible, although rarer, causes of massive hemoptysis.

Earwood JS, Thompson TD. Hemoptysis: evaluation and management. Am Fam Physician. 2015 Feb 15;91(4):243-9. PMID: 25955625.

Deshwal H, Sinha A, Mehta AC. Life-Threatening Hemoptysis. Semin Respir Crit Care Med. 2021 Feb;42(1):145–159. doi: 10.1055/s-0040-1714386. Epub 2020 Aug 30. PMID: 32862418.).

Aslaner O. Surgi̇cal treatment of li̇fe-threateni̇ng hemoptysi̇s: 15 years of experi̇ence. Med Sci. 2021;10(4):1321–6.CrossRef

Nasser M, Cottin V. The respiratory system in Autoimmune Vascular Diseases. Respiration. 2018;96(1):12–28. https://doi.org/10.1159/000486899. Epub 2018 Jul 4. PMID: 29975964.CrossRefPubMed

Rali PMD, Gandhi VMD, Tariq CMD. Massive hemoptysis. Critical care nursing Quarterly: April/June 2016 - volume 39 - issue 2 - p 139–47 https://doi.org/10.1097/CNQ.0000000000000107

Greco A, Marinelli C, Fusconi M, Macri GF, Gallo A, De Virgilio A, Zambetti G, de Vincentiis M. Clinic manifestations in granulomatosis with polyangiitis. Int J Immunopathol Pharmacol. 2016 Jun;29(2):151–9. https://doi.org/10.1177/0394632015617063. Epub 2015 Dec 18. PMID: 26684637; PMCID: PMC5806708.

Yoshimura N, Matsubara O, Tamura A, Kasuga T, Mark EJ. Wegener’s granulomatosis. Associated with diffuse pulmonary hemorrhage. Acta Pathol Jpn. 1992 Sep;42(9):657 – 61. https://doi.org/10.1111/j.1440-1827.1992.tb03047.x. PMID: 1476061.

Arora R. Massive alveolar haemorrhage: a rare life threatening complication of Wegener’s granulomatosis-report of a rare case. Quant Imaging Med Surg. 2014 Dec;4(6):509–11. https://doi.org/10.3978/j.issn.2223-4292.2014.07.03. PMID: 25525588; PMCID: PMC4256243.

Karras A, Jacquot C, Thervet E. L39. Fulminant ANCA vasculitis. Presse Med. 2013 Apr;42(4 Pt 2):607-9. https://doi.org/10.1016/j.lpm.2013.01.039. Epub 2013 Feb 26. PMID: 23453211.

10.

Li J, Li C, Li J. Thoracic manifestation of Wegener’s granulomatosis: computed tomography findings and analysis of misdiagnosis. Exp Ther Med. 2018 Jul;16(1):413–9. https://doi.org/10.3892/etm.2018.6154. Epub 2018 May 11. PMID: 29896268; PMCID: PMC5995034.

11.

Martinez F, Chung JH, Digumarthy SR, Kanne JP, Abbott GF, Shepard JA, Mark EJ, Sharma A. Common and uncommon manifestations of Wegener granulomatosis at chest CT: radiologic-pathologic correlation. Radiographics. 2012 Jan-Feb;32(1):51–69. https://doi.org/10.1148/rg.321115060. PMID: 22236893.

12.

Acharya V, Shreenivasa A, Adiga D, Mahabala C, Shenoy S, Rai S. Massive hemoptysis: a rare case with uncommon presentation and rapid response - a case report. Respir Med Case Rep. 2020 Jul;2:31:101144. https://doi.org/10.1016/j.rmcr.2020.101144. PMID: 32714822; PMCID: PMC7369350.

13.

Han M, Pan C. A case of granulomatosis with polyangiitis mimicking lung malignancy. Respirol Case Rep. 2021 Aug 9;9(9):e0824. https://doi.org/10.1002/rcr2.824. PMID: 34401189; PMCID: PMC8350426.

14.

Urbanska EM, Elversang J, Colville-Ebeling B, Löfgren JO, Nelveg-Kristensen KE, Szpirt WM. Uncommon Presentation of Granulomatosis with Polyangiitis Mimicking Metastatic Lung Cancer. Clin Pract. 2021 May 14;11(2):293–302. https://doi.org/10.3390/clinpract11020042. PMID: 34068864; PMCID: PMC8161553.

15.

Daddi N, Ferolla P, Urbani M, Semeraro A, Avenia N, Ribacchi R, Puma F, Daddi G. Surgical treatment of neuroendocrine tumors of the lung. Eur J Cardiothorac Surg. 2004 Oct;26(4):813-7. https://doi.org/10.1016/j.ejcts.2004.05.052. PMID: 15450578.

16.

Ayache M, Donatelli C, Roncin K, AnsariGilani K, Yang M, Faress J, Teba C. Massive hemorrhage after inspection bronchoscopy for carcinoid tumor. Respir Med Case Rep. 2018 May;3:24:125–8. https://doi.org/10.1016/j.rmcr.2018.05.002. PMID: 29977779; PMCID: PMC6010637.

Title: Massive, life-threatening hemoptysis due to localized granulomatosis with polyangiitis
Authors: Eleonora Coviello
Francesco Puma
Domenico Pourmolkara
Martina Mandarano
Antonio Giulio Napolitano
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Hemoptysis
Hemoptysis
Granulomatosis with Polyangiitis
Granulomatosis with Polyangiitis
Vasculitis
Vasculitis
Bronchoscopy
Published in: Journal of Cardiothoracic Surgery / Issue 1/2023
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-023-02302-5

2024 ASCO Annual Meeting

Springer Medicine

Massive, life-threatening hemoptysis due to localized granulomatosis with polyangiitis

Abstract

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2023

Grading criteria for venous invasion in thoracic esophageal squamous cell carcinoma

Stiff left atrial syndrome with pulmonary veins occlusion after percutaneous radiofrequency ablation: a life-long complication that can lead to heart transplantation

Detrimental consequences after intimal disruption of subclavian artery during transcathether aortic valve implantation

Thoracic day surgery versus thoracic inpatient surgery for treatment of patients with lung cancer: a systematic review and meta-analysis

Anatomical and biometric study of the mitral valve apparatus: application in valve repair surgery

Comparison of erector spinae plane block with paravertebral block for thoracoscopic surgery: a meta-analysis of randomized controlled trials