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• W3194350125 abstract "Objectives: To demonstrate the importance of correlating clinical data with tomographic pulmonary patterns. Methods: Descriptive. Data taken from the patient's medical history. Results: A 44-year-old man presented to the emergency room with fever, petechiae in the lower limbs, cough with hemoptoic expectoration, dyspnea and desaturation. On admission chest CT, an accentuation of the bilateral peri-hilar peri-bronchovascular interstitium was observed in ground glass associated with the presence of areas of centroacinar infiltrate that, in the first instance, were interpreted as suggestive of COVID-19 pneumonia. The following day, the patient presented progression of his dyspnea, requiring oxygen therapy by high-flow cannula and the pulmonary infiltrates progressed in extension and attenuation of the diffuse ground glass, with diffuse septal thickening, a typical crazy paving pattern (Figure 1);his nasopharyngeal swab for rtPCR for SARS-CoV2 was negative. The patient was re-questioned, referring to a weight loss of more than 10 kg in the last 3 months. The febrile episodes were at evening, intermittent, of the same evolution time, associated with profuse sweating and infrapatellar paresthesias. Previous studies were collected and comparing them with the current ones, there was a marked drop in hematocrit, hypereosinophilia and elevation of acute phase reactants (Table 1). Urine examination showed the presence of red blood cells >50/hpf, granular casts and 80% of acantocytes. Given the suspicion of a pulmonary renal syndrome (DAH + GN), pulses of Methylprednisolone are started, management in ICU and study of its vasculitic etiology. Already in the second corticosteroid pulse, the patient showed a clear improvement in clinical, laboratory and imaging parameters. A kidney biopsy was performed due to proteinuria of 1.2 g/day. The histopathological report reported: focal segmental necrotizing GN pauciimmune. With cANCA/AntiPR3 positivity, the condition is interpreted asAVV(EGPA). The patient is currently on the 2nd pulse of cyclophosphamide, with a good response to it, and a gradual decrease in glucocorticoids therapy. Conclusion: It seemed important to us to present this case because, given the current situation of the pandemic that we face, the frequently interstitial pattern in ground glass that COVID-19 pneumonia presents, misleads us from cases like this, a diffuse alveolar hemorrhage and with it a delay in the diagnostic suspicion and its imperative beginning in the treatment." @default.
• W3194350125 created "2021-08-30" @default.
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• W3194350125 date "2021-01-01" @default.
• W3194350125 modified "2023-09-27" @default.
• W3194350125 title "The 'crazy paving' pattern: Covid pneumonia or diffuse alveolar hemorrhage?" @default.
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