Microscopic polyangiitis in a case of silica exposure: a rare presentation

  • Nitesh Gupta Department of Pulmonary, Critical Care and Sleep Medicine, Safdarjung Hospital, New Delhi, India.
  • A J Mahendran Department of Pulmonary, Critical Care and Sleep Medicine, Safdarjung Hospital, New Delhi, India.
  • Shibdas Chakrabarti Department of Pulmonary, Critical Care and Sleep Medicine, Safdarjung Hospital, New Delhi, India.
  • Sumita Agrawal | doc.sumitaagrawal@gmail.com Department of Pulmonary, Critical Care and Sleep Medicine, Safdarjung Hospital, New Delhi, India.

Abstract

A 28-year-old male was admitted for breathlessness, haemoptysis, fever and fatigue. The patient had occupational exposure to silica dust. Arterial blood gas test ABG revealed hypoxemic respiratory failure. Chest CT demonstrated ground glass opacities with interlobular septal thickening and small centrilobular nodules with patchy areas of consolidation in bilateral lungs. He was mechanically ventilated for refractory hypoxemia. The treatment with cyclophosphamide and methylprednisolone lead to recovery and extubation. The final diagnosis was diffuse alveolar haemorrhage due to perinuclear antineutrophil cytoplasmic antibody (ANCA)-associated microscopic polyangiitis (p-ANCA-associated MPA). In a tuberculosis endemic country, for patients presenting with diffuse alveolar haemorrhage (DAH), with history of silica exposure, differential diagnosis of ANCA associated vasculitis must be considered.

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Published
2019-09-10
Info
Issue
Section
Pneumology - Case Reports
Keywords:
Vasculitis, respiratory failure, diffuse alveolar haemorrhage
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How to Cite
Gupta, N., Mahendran, A. J., Chakrabarti, S., & Agrawal, S. (2019). Microscopic polyangiitis in a case of silica exposure: a rare presentation. Monaldi Archives for Chest Disease, 89(3). https://doi.org/10.4081/monaldi.2019.1087