Aged ; Extracorporeal Membrane Oxygenation ; methods ; Female ; Hemoptysis ; pathology ; surgery ; Humans ; Silicones ; chemistry ; Stents ; Trachea ; pathology ; surgery

Adult ; Bronchi ; diagnostic imaging ; pathology ; Bronchial Diseases ; etiology ; pathology ; Female ; Hemoptysis ; etiology ; pathology ; Humans ; Young Adult

Idiopathic pulmonary hemosiderosis (IPH) is a rare respiratory disease with an unknown etiology, and is diagnosed with laboratory, radiology, and pathology tests. Chief complaints of IPH include hemoptysis, cough, and dyspnea. Since it is considered an immune-mediated disease, the first line of treatment is systemic corticosteroid therapy. The three cases reported here showed a decrease in ferritin level and improvement in the hemoglobin level with prednisolone treatment. However, long-term corticosteroid therapy may cause several side effects, particularly growth retardation and obesity, which can affect growing children. In the present study, all patients had cushingoid symptoms and obesity. Therefore, we switched to deflazacort (DFZ), which has lesser side-effects of weight gain. This report describes clinical courses of the disease and comparison of body mass index of three patients with IPH who took DFZ instead of prednisolone. DFZ was effective for IPH, and is useful for weight gain reduction.
Body Mass Index ; Child ; Cough ; Dyspnea ; Ferritins ; Hemoptysis ; Hemosiderosis ; Humans ; Obesity ; Pathology ; Prednisolone ; Weight Gain

Pulmonary hemorrhage as the initial manifestation of systemic lupus erythematosus (SLE) has been rarely reported in children. We present the case of a 10-year-old girl who was admitted to Kangbuk Samsung Hospital with hemoptysis. She had a 5-day history of cough with dyspnea. On physical exam, breath sound was significantly decreased combined with rales on both lung fields. Blood tests revealed pancytopenia, decreased complement levels (C3, 21.28 mg/dL; C4, 3.10 mg/dL), positive antinuclear antibody (>1:640) and anti-double-stranded DNA antibody (262.5 IU/mL). Chest computed tomography revealed patchy ground glass opacity on both lung fields. She had proteinuria and diffuse lupus nephritis (International Society of Nephrology/Renal Pathology Society class IV-G(A)) confirmed by renal biopsy. High-dose methylprednisolone pulse therapy (30 mg/kg/day) was given for 3 days and then switched to a maintenance dose (1 mg/kg/day). Initially hemoptysis resolved after administration of methylprednisolone, but recurred on the 14th day of treatment. She was then treated with cyclophosphamide pulse therapy and hemoptysis subsided without recurrence. She was discharged on the 31st day of admission. She continued to receive monthly cyclophosphamide pulse therapy until the occurrence of leukopenia and then her regimen was switched to mycophenolate and hydroxychloroquine. SLE continues to be well controlled after 18 months of treatment. Recognition of pulmonary hemorrhage as a possible initial manifestation of SLE is crucial for early diagnosis. SLE was successfully treated with good outcome.
Antibodies, Antinuclear ; Biopsy ; Child ; Complement System Proteins ; Cough ; Cyclophosphamide ; DNA ; Dyspnea ; Early Diagnosis ; Female ; Glass ; Hematologic Tests ; Hemoptysis ; Hemorrhage* ; Humans ; Hydroxychloroquine ; Leukopenia ; Lung ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Methylprednisolone ; Pancytopenia ; Pathology ; Pediatrics ; Proteinuria ; Recurrence ; Respiratory Sounds ; Thorax

Published reports about polyps of larynx at the ventricular bands are extremely rare. The first symptom of this case presents recurrent hemoptysis. The video laryngoscope demonstrated that a smooth-faced and hyperemic polypoid lesion was found in the anterior part of the right false vocal cord, close to laryngeal surface of epiglottis. Postoperative pathological report revealed that the mass was a vascular polyp.
Hemoptysis ; diagnosis ; pathology ; Humans ; Larynx ; pathology ; Polyps ; diagnosis ; pathology ; Postoperative Period ; Vocal Cords ; pathology

Adult ; Aneurysm ; complications ; Bronchial Arteries ; pathology ; Extracorporeal Membrane Oxygenation ; methods ; Female ; Hemoptysis ; etiology ; therapy ; Humans

Arteriovenous Fistula ; diagnostic imaging ; pathology ; surgery ; Hemoptysis ; surgery ; Humans ; Male ; Middle Aged ; Pulmonary Artery ; abnormalities ; diagnostic imaging ; pathology ; surgery ; Pulmonary Veins ; abnormalities ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

Malignant airway obstruction and hemoptysis are common in lung cancer patients. Recently, airway stent is commonly used to preserve airway in malignant airway obstruction. Hemoptysis can be managed through various methods including conservative treatment, endobronchial tamponade, bronchoscopic intervention, embolization and surgery. In our case studies, we sought to investigate the effectiveness of airway stents for re-opening the airway as well as tamponade effects in four patients with malignant airway obstruction and bleeding caused by tumors or lymph node invasions.
Aged ; Airway Obstruction/*etiology/pathology/*therapy ; Alloys ; Bronchoscopy ; Carcinoma, Non-Small-Cell Lung/*complications ; Fatal Outcome ; Fluoroscopy ; Hemoptysis/*etiology/pathology/*therapy ; Humans ; Lung Neoplasms/*complications ; Male ; Middle Aged ; *Stents

A 27-year-old man presented at the emergency room with hemoptysis. His blood pressure was 180/100 mm Hg, and he had no history of hypertension. Chest radiographs showed bilateral infiltration, suggestive of alveolar hemorrhage. His laboratory data were consistent with acute kidney injury. His serum creatinine level increased abruptly; therefore, renal biopsy was performed. Steroid pulse therapy was administered because of a strong suspicion of immune-mediated pulmonary renal syndrome. Renal biopsy showed proliferative endarteritis, fibrinoid necrosis, and intraluminal thrombi in the vessels without crescent formation or necrotizing lesions. Steroid pulse therapy rapidly tapered and stopped. His serum creatinine level gradually decreased with strict blood pressure control. Ten months after discharge, his blood pressure was approximately 120/80 mm Hg with a serum creatinine level of 1.98 mg/dL. Pulmonary renal syndrome is generally caused by an immune-mediated mechanism. However, malignant hypertension accompanying renal insufficiency and heart dysfunction causing end-organ damage can create a pulmonary hemorrhage, similar to pulmonary renal syndrome caused by an immune-mediated mechanism. The present case shows that hypertension, a common disease, can possibly cause pulmonary renal syndrome, a rare condition.
Adult ; Glomerulonephritis/*diagnosis ; Hemoptysis/pathology ; Hemorrhage/*diagnosis ; Humans ; Hypertension, Malignant/*diagnosis ; Lung Diseases/*diagnosis ; Male

A 60-year-old man presented with cough, sputum, and dyspnea. He had a history of acute myeloid leukemia and hematopoietic stem cell transplantation with chronic renal failure. Chest CT scans showed miliary nodules and patchy consolidations. Histological examination revealed numerous fibrin balls within the alveoli and thickening of the alveolar septum, both of which are typical pathological features of acute fibrinous and organizing pneumonia (AFOP). We report the first case of AFOP following allogeneic hematopoietic stem cell transplantation.
Acute Disease ; Anti-Bacterial Agents/therapeutic use ; Biopsy ; Cryptogenic Organizing Pneumonia/etiology/pathology ; Fatal Outcome ; Glucocorticoids/administration & dosage ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Hemoptysis/etiology ; Humans ; Leukemia, Myeloid, Acute/*surgery ; Lung Diseases/*etiology/pathology ; Male ; Middle Aged ; Pleural Effusion/etiology ; Pulse Therapy, Drug ; Radiography, Thoracic ; Respiratory Insufficiency/etiology ; Tomography, X-Ray Computed