CTICasesPulmonary Hemorrhage (Capillaritis) in Antiphospholipid Antibody Syndrome
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Imaging findings
Serial chest radiographs and CT scans showed recurrent episodes of patchy, confluent, multilobar ground-glass opacities. Initially, these findings were diffuse, then appeared similar but less severe on follow-up.
Key takeaways
Antiphospholipid antibody syndrome (APLS) can present with recurrent pulmonary hemorrhage, even in the absence of a history of thrombosis. The underlying mechanism is thought to be immune-related capillaritis (specifically, neutrophilic capillaritis confirmed by lung biopsy), leading to alveolar hemorrhage. Hemoglobin-laden macrophages in bronchoalveolar lavage are indicative of pulmonary hemorrhage. This is a rare but recognized manifestation of APLS.
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