Extracorporeal membrane oxygenation in life-threatening ANCA-positive diffuse necrotizing alveolar hemorrhage


DOI: https://dx.doi.org/10.18565/nephrology.2018.3.57-62

M.A. Lysenko, N.F. Frolova, M.V. Ketskalo, E.N. Dyakova, I.L. Sysoeva, T.R. Zhilinskaya, O.N. Kotenko, G.V. Volgina

1 SBCHI "City Clinical Hospital № 52 of the Moscow Healthcare Department"; Moscow, Russia; 2 FSBEI HE "A.I. Yevdokimov Moscow State University of Medicine and Dentistry" of the Ministry of Health of the Russian Federation; Moscow, Russia; 3 FSAEI HE "Peoples' Friendship University of Russia"; Moscow, Russia
Pulmonary pathology in microscopic polyangiitis (MPA) is diagnosed in 25–70% of cases and is primarily represented by necrotizing hemorrhagic alveolitis, which can be the initial manifestation of an autoimmune disease and is a life-threatening pathology requiring the clinician to immediately diagnose and promptly assign adequate pathogenetic therapy. A case of fatal hemorrhagic pneumonitis with pulmonary hemorrhage and rapidly progressive glomerulonephritis due to MPA is presented. According to the ineffectiveness of the artificial lung ventilation, the patient had required the extracorporeal membrane oxygenation, that had improved the respiratory function of the lungs until the development of clinical effectiveness of pathogenetic therapy of MPA, including high-volume plasma exchange, high doses of corticosteroids, immunoglobulins and cytostatics.
Keywords: microscopic polyangiitis, hemorrhagic alveolitis, acute respiratory failure, extracorporeal membrane oxygenation
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About the Autors

Lysenko M.A. – Doctor of Medical Sciences, Chief Physician of the SBCHI "City Clinical Hospital № 52 of the Moscow Healthcare Department"; Moscow, Russia.
Frolova N.M. – PhD in Medical Science, Head of the 2-nd Nephrological Department, Nephrologist at the SBCHI "City Clinical Hospital № 52 of the Moscow Healthcare Department"; Moscow, Russia.
Ketskalo M.V. – PhD in Medical Science, Anesthesiologist-Reanimatologist, Head of the Center for Extracorporeal Membrane Oxygenation of the SBCHI "City Clinical Hospital № 52
of the Moscow Healthcare Department"; Moscow, Russia.
Dyakova E.N. – Nephrologist at the 2nd Nephrological Department of the SBCHI "City Clinical Hospital № 52 of the Moscow Healthcare Department"; Moscow, Russia.
Sysoeva LN – Nephrologist at the 2nd Nephrological Department of the SBCHI "City Clinical Hospital № 52 of the Moscow Healthcare Department"; Moscow, Russia.
Zhilinskaya T.R. – Nephrologist at the Consultative and Diagnostic Nephrological Department of the SBCHI "City Clinical Hospital № 52 of the Moscow Healthcare Department"; Moscow, Russia.
Kotenko O.N. – PhD in Medical Science, Chief Freelance Nephrologist at the Moscow Healthcare Department, Deputy Chief Physician for Nephrology of the SBCHI "City Clinical Hospital № 52 of the Moscow Healthcare Department", Associate Professor at the Department of Hospital Therapy with the Course of Hematology of FSAEI HE PFUR; Moscow, Russia.
E-mail: olkotenko@yandex.ru
Volgina G.V. – Doctor of Medical Sciences, Prof. at the Department of Nephrology FAPE GSBEI HE . A.I. Yevdokimov MSMSU of the Mistry of Health of the Russian Federation; Moscow, Russia. E-mail: Volginagv@mail.ru

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