Year: 2023
Type: article
Study design: Case Report
Abstract: Diffuse alveolar hemorrhage (DAH) is a dreaded and life-threatening complication.Although it is rarely reported in postoperative orthopaedic patients but few cases of fat embolism-associated DAH had been reported in the literature.We report a postoperative intramedullary femur patient with underlying undiagnosed vasculitis presenting as diffuse alveolar hemorrhage.A 56-year-old gentleman suffered a right femur fracture, managed with an interlocking nail.On postoperative day 4, the patient presented with hemoptysis, dyspnea, and a sudden fall in hematocrit suspecting diffuse alveolar hemorrhage (DAH).Pulmonary angiography and other investigations were not suggestive of pulmonary tromboembolism or fat embolism.Vasculitis was then suspected and cAN-CA(PR3) antibodies were positive.The patient was managed with corticosteroids, methotrexate, and oxygen supplementation.At 1 year follow-up, the femur fracture had united with no respiratory problem.As a conclusion, vasculitis, though a rare cause of DAH in post-operative orthopaedic surgery patients should be kept in mind.
Source: Respiratory Case Reports
Authors: Bushu Harna, Shivali Arya, Lalit Gupta
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4388052575