. 2016; 5(1): 43-48 | DOI: 10.5505/respircase.2016.86658 | |||
INTERACTIVE CASE REPORT: Sevoflurane-related Isolated Pulmonary Vasculitis: A New Etiological Cause of Diffuse Alveolar Hemorrhage?Ufuk Turhan1, Mehmet Aydoğan2, Erol Kılıç3, Hatice Kaya1, Alper Gündoğan4, Yıldırım Karslıoğlu5, Ergün Uçar1, Hayati Bilgiç11Department of Pulmonology, Gülhane Military Medical Academy, Ankara, Turkey2Clinic of Pulmonology, Isparta Military Hospital, Isparta, Turkey 3Clinic of Pulmonology, Kasımpaşa Military Hospital, İstanbul, Turkey 4Clinic of Pulmonology, Diyarbakır Military Hospital, Diyarbakır, Turkey 5Department of Pathology, Gülhane Military Medical Academy, Ankara, Turkey Pulmonary capillaritis is the small-vessel vasculitis of the lungs. We report a case of isolated pulmonary capillaritis presenting with diffuse alveolar hemorrhage, which is not associated with ANCA. The patient had shortness of breath that developed after myomectomy surgery: sevoflurane was used as a general anesthetic in the operation. The thorax HRCT scans showed ground glass opacities in both lungs and consolidation in the right lower lobe. Due to hemorrhagic and darkening of the BAL fluid as aspirated, it was thought that the diagnosis was in accordance with alveolar hemorrhage. The patient responded well to methylprednisolone therapy. The transbronchial lung biopsies revealed vasculitis. ANCA and other rheumatologic markers were negative. Due to the absence of systemic symptoms, we diagnosed ANCA negative isolated pulmonary capillaritis. Rapid diagnosis and pulse steroid therapy are of vital importance in these patients. It should be kept in mind that inhalation anesthetics could be responsible for cases of DAH and SPC. Keywords: Diffuse alveolar hemorrhage, isolated pulmonary capillaritis, sevofluraneİNTERAKTİF OLGU SUNUMU: Sevofluran'a Bağlı İzole Pulmoner Vaskülit: Yaygın Pulmoner Hemorajinin Yeni bir Nedeni mi?Ufuk Turhan1, Mehmet Aydoğan2, Erol Kılıç3, Hatice Kaya1, Alper Gündoğan4, Yıldırım Karslıoğlu5, Ergün Uçar1, Hayati Bilgiç11Gülhane Askeri Tıp Akademisi, Göğüs Hastalıkları Anabilim Dalı, Ankara2Isparta Asker Hastanesi, Göğüs Hastalıkları Kliniği, Isparta 3Kasımpaşa Asker Hastanesi, Göğüs Hastalıkları Kliniği, İstanbul 4Diyarbakır Asker Hastanesi, Göğüs Hastalıkları Kliniği, Diyarbakır 5Gülhane Askeri Tıp Akademisi, Patoloji Anabilim Dalı, Ankara Pulmoner kapillerit akciğerin küçük damarlarının vaskülitidir. Kollajen vasküler hastalık ya da ANCA ilişkili vaskülitlerin parçası olarak, izole pauci-immün kapillerit veya akciğer transplant rejeksiyonunda görülebilir. Biz, ANCA ilişkili olmayan ve sistemik tutulum göstermeyen, diffüz alveoler hemoraji (DAH) tablosu ile prezente olan “İzole Pulmoner Kapillerit (İPK)” olgusunu sunuyoruz. Miyomektomi operasyonu sonrası gelişen nefes darlığıyla konsülte edilen hastaya, operasyonda genel anestezik olarak sevofluran Tomography Slices of the Case
Ufuk Turhan, Mehmet Aydoğan, Erol Kılıç, Hatice Kaya, Alper Gündoğan, Yıldırım Karslıoğlu, Ergün Uçar, Hayati Bilgiç. INTERACTIVE CASE REPORT: Sevoflurane-related Isolated Pulmonary Vasculitis: A New Etiological Cause of Diffuse Alveolar Hemorrhage?. . 2016; 5(1): 43-48 Corresponding Author: Ufuk Turhan, Türkiye |
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