Coughing up clues: 16-year-old girl with acute haemoptysis. Issue 1 (8th January 2020)

• Record Type: Journal Article
• Authors: Cheng, Daryl R; Silverman, Earl D; Cho, Romy
• Is Part Of: BMJ case reports. Volume 13:Issue 1(2020)
• Publication Date: 2020-01-08
• Subjects: paediatrics -- vasculitis; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-233251
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 16-year-old previously well girl presented with bilateral painful lower leg swelling and non-pruritic blanching rash across her torso and upper and lower limbs. These symptoms started after commencing amoxicillin for presumed tonsillitis. She was diagnosed with serum sickness-like illness and started on non-steroidal agents. The rash and painful leg swelling improved over the next 48 hours. However, she subsequently developed fevers, cough and new-onset haemoptysis. She continued to deteriorate with increasing amounts of haemoptysis, work of breathing and escalating respiratory support requirements. Serial chest radiographs showed worsening lung consolidation and enlarging pleural effusion. A CT chest revealed extensive bilateral lung consolidation, most likely pulmonary haemorrhage. Subsequent investigations showed positive classic antineutrophil cytoplasmic antibody, confirming the diagnosis of granulomatosis with polyangiitis.