PMID- 26058459
OWN - NLM
STAT- MEDLINE
DCOM- 20150928
LR  - 20181113
IS  - 1546-0096 (Electronic)
IS  - 1546-0096 (Linking)
VI  - 13
DP  - 2015 Jun 10
TI  - Concurrent pulmonary hemorrhage and deep vein thrombosis in a child with 
      ANCA-associated vasculitis: case report and review of literature.
PG  - 20
LID - 10.1186/s12969-015-0015-y [doi]
LID - 20
AB  - Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is an uncommon 
      but potentially life threatening disease in children. Pulmonary hemorrhage (PH) 
      is a well recognized but lethal complication. The incidence of venous 
      thromboembolism (VTE) is higher in patients with AAV, especially in those with 
      active disease. However, the simultaneous occurrence of both PH and VTE has 
      rarely been reported. Herein, we describe a 14-year-old female with AAV who 
      developed concomitant deep vein thrombosis (DVT) and PH within 3 days after 
      hospitalization. She was successfully treated with timely plasmapheresis and 
      methylprednisolone pulse therapy. VTE did not occur during discontinuation of 
      anticoagulant. On reviewing the English literature, 5 AAV patients with 
      coexisting VTE and PH have been reported. When faced with PH, whether or not to 
      keep anti-coagulation treatment is a dilemma. Some of the patients kept receiving 
      anti-coagulation treatment, whereas others undergoing inferior vena cava filter 
      implantation. Glucocorticoids and cyclophosphamide or other immunosuppressant 
      agents were prescribed in all patients. All of the cases survived after treatment 
      for concurrent VTE and PH, and received short- or long-term anticoagulation 
      treatment after discharge. To the best of our knowledge, this is the first report 
      of a pediatric patient with AAV presenting with coexistent VTE and PH. VTE should 
      be considered to be a sign of disease flare-up, and early plasmapheresis with 
      immunosuppressant therapy can rescue this fatal complication.
FAU - Tseng, Shi-Ting
AU  - Tseng ST
AD  - Division of Pediatric Allergy, Asthma and Rheumatology, Department of Pediatrics, 
      Chang Gung Memorial Hospital and Chang Gung University, Linkou 5, Fu-Hsin Street, 
      Taoyuan, Taiwan. b9102032@cgmh.org.tw.
FAU - Tseng, Min-Hua
AU  - Tseng MH
AD  - Division of Pediatric Nephrology, Department of Pediatrics, Chang Gung Memorial 
      Hospital and Chang Gung University, Linkou 5, Fu-Hsin Street, Taoyuan, Taiwan. 
      doc31089@gmail.com.
FAU - Huang, Jing-Long
AU  - Huang JL
AD  - Division of Pediatric Allergy, Asthma and Rheumatology, Department of Pediatrics, 
      Chang Gung Memorial Hospital and Chang Gung University, Linkou 5, Fu-Hsin Street, 
      Taoyuan, Taiwan. long@adm.cgmh.org.tw.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20150610
PL  - England
TA  - Pediatr Rheumatol Online J
JT  - Pediatric rheumatology online journal
JID - 101248897
RN  - 0 (Glucocorticoids)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Adolescent
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications
MH  - Comorbidity
MH  - Female
MH  - Glucocorticoids/therapeutic use
MH  - Hemorrhage/*diagnosis/etiology/therapy
MH  - Humans
MH  - Lung Diseases/*diagnosis/etiology/therapy
MH  - Methylprednisolone/therapeutic use
MH  - Plasmapheresis
MH  - Treatment Outcome
MH  - Venous Thrombosis/*diagnosis/etiology/therapy
PMC - PMC4461945
EDAT- 2015/06/11 06:00
MHDA- 2015/09/29 06:00
PMCR- 2015/06/10
CRDT- 2015/06/11 06:00
PHST- 2014/11/13 00:00 [received]
PHST- 2015/05/15 00:00 [accepted]
PHST- 2015/06/11 06:00 [entrez]
PHST- 2015/06/11 06:00 [pubmed]
PHST- 2015/09/29 06:00 [medline]
PHST- 2015/06/10 00:00 [pmc-release]
AID - 10.1186/s12969-015-0015-y [pii]
AID - 15 [pii]
AID - 10.1186/s12969-015-0015-y [doi]
PST - epublish
SO  - Pediatr Rheumatol Online J. 2015 Jun 10;13:20. doi: 10.1186/s12969-015-0015-y.