Delayed Development of Pulmonary Hemorrhage in a Patient with Positive Circulating Anti-Neutrophil Cytoplasmic Antibody: A Clinical Dilemma Case Rep Nephrol.

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Fig. 16. Spontaneous pulmonary hematoma and hemorrhage in a 54-year-old man.A. Initial CT image shows small bullae (arrow) in the right upper lobe. B. Follow-up.

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Delayed Development of Pulmonary Hemorrhage in a Patient with Positive Circulating Anti-Neutrophil Cytoplasmic Antibody: A Clinical Dilemma Case Rep Nephrol Urol 2013;3:121-127 - DOI:10.1159/000355509 Fig. 1. Time course of pulmonary lesions in our patient. a In a kidney biopsy performed in December 1996, interstitial changes of the lungs and pleural thickening (arrowheads) were the principal findings. b Chest CT from September 2001 shows little change. c Chest CT from October 2010 shows infiltrative shadows (arrows) in bilateral inferior lobes, simultaneously with hemoptysis. d Chest CT 2 days later in October 2010 shows disappearance of the hemorrhagic shadows shortly after initiation of steroid therapy. © 2013 S. Karger AG, Basel - CC BY-NC 3.0

Delayed Development of Pulmonary Hemorrhage in a Patient with Positive Circulating Anti-Neutrophil Cytoplasmic Antibody: A Clinical Dilemma Case Rep Nephrol Urol 2013;3:121-127 - DOI:10.1159/000355509 Fig. 2.a Course of serum Cr levels and MPO-ANCA titers from the time of renal biopsy until initiation of HD. Arrows indicate plasma exchange therapy; inverted triangle indicates granulocytapheresis.b Normalization of circulating MPO-ANCA following steroid therapy against alveolar hemorrhage.m-PSL = 3-day infusion of 500 mg methylprednisolone. © 2013 S. Karger AG, Basel - CC BY-NC 3.0