TY - JOUR
T1 - Rheumatoid arthritis causing diffuse alveolar haemorrhage
T2 - A novel therapeutic approach
AU - Osman, Afaf
AU - Galiatsatos, Panagis
AU - Bose, Sonali
AU - Danoff, Sonye
N1 - Publisher Copyright:
© BMJ Publishing Group Ltd 2017. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Pulmonary vascular involvement due to rheumatoid arthritis, presenting as diffuse alveolar haemorrhage (DAH), is a rare phenomenon, especially if there are no signs of systemic vasculitides. Furthermore, how to proceed with the management of these patients is challenging, as in the case of our patient, who had recurrent DAH. We present a case of a patient with known rheumatoid arthritis who had recurrence of DAH that spanned over several years, often presenting with life-threatening respiratory failure. While her DAH presentation improved with high-dose glucocorticoids, to resolve her recurrence, we opted to initiate treatment with rituximab, with a short course of azathioprine. After the second round of rituximab, the patient continues to do well without any further DAH-related complications. We also summarise prior cases of such patients to highlight variable treatment options.
AB - Pulmonary vascular involvement due to rheumatoid arthritis, presenting as diffuse alveolar haemorrhage (DAH), is a rare phenomenon, especially if there are no signs of systemic vasculitides. Furthermore, how to proceed with the management of these patients is challenging, as in the case of our patient, who had recurrent DAH. We present a case of a patient with known rheumatoid arthritis who had recurrence of DAH that spanned over several years, often presenting with life-threatening respiratory failure. While her DAH presentation improved with high-dose glucocorticoids, to resolve her recurrence, we opted to initiate treatment with rituximab, with a short course of azathioprine. After the second round of rituximab, the patient continues to do well without any further DAH-related complications. We also summarise prior cases of such patients to highlight variable treatment options.
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U2 - 10.1136/bcr-2017-220509
DO - 10.1136/bcr-2017-220509
M3 - Article
C2 - 28619978
AN - SCOPUS:85020838600
SN - 1757-790X
VL - 2017
JO - BMJ case reports
JF - BMJ case reports
ER -