CTICasesANCA-Associated Vasculitis (Microscopic Polyangiitis) Presenting with Diffuse Alveolar Hemorrhage
Imaging findings
Chest CT in a patient with acute renal failure shows new bilateral areas of ground-glass opacity and nodularity, with some areas exhibiting a tree-in-bud or branching nodular appearance. Bronchoscopic lavage confirms diffuse alveolar hemorrhage, and serology reveals positive ANCA and MPO titers, establishing microscopic polyangiitis.
Key takeaways
Microscopic polyangiitis is an ANCA-associated small-vessel vasculitis that typically presents with necrotizing glomerulonephritis and pulmonary capillaritis leading to diffuse alveolar hemorrhage. Concomitant anticoagulation, such as for a mechanical aortic valve, can exacerbate the severity of the pulmonary hemorrhage.
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