Life-threatening antineutrophil cytoplasmic antibody–associated vasculitis after influenza A H1N1 infection requiring veno-venous extracorporeal membrane oxygenation. (September 2020)

• Record Type: Journal Article
• Authors: Frantzeskaki, Frantzeska G.; Dimopoulos, Stavros; Konstantonis, Dimitrios; Katsibri, Pelagia; Kostopanagiotou, Kostantinos; Theodorakopoulou, Maria; Diakaki, Chrysi; Dougenis, Dimitrios; Boumpas, Dimitrios; Karabinis, Andreas; Armaganidis, Apostolos; Tsangaris, Iraklis
• Is Part Of: Perfusion. Volume 35:Number 6(2020)
• Page Start: 546
• Page End: 549
• Publication Date: 2020-09
• Subjects: antineutrophil cytoplasmic autoantibody–associated vasculitis -- acute respiratory distress syndrome -- diffuse alveolar hemorrhage -- extracorporeal membrane oxygenation -- renal replacement therapy; Perfusion (Physiology) -- Periodicals; Blood -- Circulation, Artificial -- Periodicals; Heart -- Surgery -- Periodicals; Extracorporeal Circulation -- Periodicals; Perfusion -- Periodicals; Circulation extracorporelle -- Périodiques; Perfusion -- Périodiques; 617.41
• DOI: 10.1177/0267659120927210
• Languages: English
• ISSNs: 0267-6591

Abstract

Introduction: Antineutrophil cytoplasmic autoantibody–associated vasculitis is an immune-mediated necrotizing vasculitis, affecting small- and medium-sized vessels. Case report: A 22-year-old female patient with free medical history presented with life-threatening pulmonary hemorrhage due to antineutrophil cytoplasmic autoantibody–associated vasculitis, temporarily associated with influenza A H1N1 infection. Due to rapidly worsening respiratory failure, despite conventional management, veno-venous peripheral extracorporeal membrane oxygenation was initiated and continued for 26 days, with subsequent renal replacement therapy. Discussion: We present a case of severe antineutrophil cytoplasmic autoantibody–associated pulmonary vasculitis, managed with veno-venous extracorporeal membrane oxygenation at the initial phase. Despite the significant challenges raised with the use of extracorporeal membrane oxygenation in pulmonary hemorrhage cases, extracorporeal membrane oxygenation may have a significant impact on outcome in this setting, by providing adequate time for a successful immunosuppressive treatment.