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Perfusion . Life-threatening Antineutrophil Cytoplasmic Antibody-Associated Vasculitis After Influenza A H1N1 Infection Requiring Veno-Venous Extra

tetano

Editor, Senior Moderator
Perfusion


. 2020 Jun 12;267659120927210.
doi: 10.1177/0267659120927210. Online ahead of print.
Life-threatening Antineutrophil Cytoplasmic Antibody-Associated Vasculitis After Influenza A H1N1 Infection Requiring Veno-Venous Extracorporeal Membrane Oxygenation


Frantzeska G Frantzeskaki[SUP] 1 [/SUP], Stavros Dimopoulos[SUP] 2 [/SUP], Dimitrios Konstantonis[SUP] 1 [/SUP], Pelagia Katsibri[SUP] 3 [/SUP], Kostantinos Kostopanagiotou[SUP] 4 [/SUP], Maria Theodorakopoulou[SUP] 1 [/SUP], Chrysi Diakaki[SUP] 1 [/SUP], Dimitrios Dougenis[SUP] 4 [/SUP], Dimitrios Boumpas[SUP] 3 [/SUP], Andreas Karabinis[SUP] 2 [/SUP], Apostolos Armaganidis[SUP] 1 [/SUP], Iraklis Tsangaris[SUP] 1 [/SUP]



Affiliations

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.

Keywords: acute respiratory distress syndrome; antineutrophil cytoplasmic autoantibody–associated vasculitis; diffuse alveolar hemorrhage; extracorporeal membrane oxygenation; renal replacement therapy.
 
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