A Case of Recurrent Pulmonary Hemorrhage in p-ANCA-Related Vasculitis Patients on Hemodialyis

Korean Journal of Nephrology 2007;26(4):495-501.

Eun Hoe Kwon, M.D.1, Young Eun Park, M.D.2 , Sang Heon Song, M.D.2, Dong Won Lee, M.D.2, Soo Bong Lee, M.D.2 and Ihm Soo Kwak, M.D.2

Department of Internal Medicine, Hae-dong hospital1; Department of Internal Medicine²
Pusan National University School of Medicine, Busan, Korea

혈액투석 중인 p-ANCA 연관성 혈관염 환자의 재발성 폐출혈 1예

권은회1

해동병원 내과1, 부산대학교 의학대학원 내과학교실2

Abstract

ANCA-associated vasculitis is one of the immunologic cause of diffuse alveolar hemorrhage (DAH). We experienced a rare case of recurrent DAH in a 67-year-old man with ANCA-associated vasculitis who had been on maintenance hemodialysis. Two years ago, he presented with renal failure and hemoptysis. Hemoptysis caused by DAH was resolved immediately and hemodialysis was applied because of persistent uremic symptom. On maintenance hemodialysis, three recurrences have happened so far. At present, oral prednisolone and oral cyclophosphamide are being maintained during outpatient follow-up. Our report suggests that the nephrologist must be concerned about the possibility of recurrent aleveolar hemorrhage in ANCA associated renal disease patients and consider immunosuppressive treatment, even though the patient has been on maintenance hemodialysis.

Key Words: Hemoptysis, P-ANCA, Vasculitis, Hemodialysis