CTICasesGranulomatosis with Polyangiitis (GPA) presenting as Diffuse Alveolar Hemorrhage
Imaging findings
Chest radiograph and CT scan demonstrate bilateral, multifocal, discrete areas of consolidation and ground-glass opacity, showing a peribronchial distribution with relative subpleural sparing. Kidney biopsy confirmed a necrotizing granulomatous vasculitis.
Key takeaways
While granulomatosis with polyangiitis (GPA) more commonly presents with pulmonary nodules or cavities, it can rarely manifest as diffuse alveolar hemorrhage (DAH). A high index of suspicion and multi-organ evaluation, such as a renal biopsy demonstrating necrotizing granulomatous vasculitis, is essential for confirming the diagnosis of GPA in the setting of pulmonary hemorrhage.
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