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The lung in vasculitis 

The lung in vasculitis

Chapter:
The lung in vasculitis
Author(s):

A.U. Wells

and Roland M. du Bois

DOI:
10.1093/med/9780199204854.003.181105

Relevant case histories from Oxford Case Histories in Respiratory Medicine has been added to this chapter.

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date: 27 May 2017

Case History—A 70 yr old man with a short history of severe breathlessness and widespread consolidation on his chest radiograph.

Case History—A 29 yr old woman with known asthma, now presenting with worsening respiratory and systemic symptoms.

Lung involvement in vasculitic disease can manifest in two ways: (1) Diffuse alveolar haemorrhage—presenting features include fever, weight loss, and other systemic symptoms in association with cough, breathlessness, and clinical signs suggestive of pneumonia. Haemoptysis may be present but is not invariable. A fall in haemoglobin over a day or longer is diagnostically useful. Bronchoalveolar lavage is usually diagnostic. (2) Other pulmonary vasculopathies—present with breathlessness on exertion. Investigation reveals isolated reduction in gas transfer (carbon monoxide diffusing capacity, D...

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