Alveolar hemorrhage (AH) is a clinical manifestation with high mortality rate that must be promptly investigated, recognized and stabilized. Causes of AH include systemic and respiratory tract infections, arterio-venous malformations, blood dyscrasias and autoimmune diseases such as systemic lupus erithematosus, Goodpasture syndrome and primary systemic vasculitis, specially the antineutrophil cytoplasmic antibodies-associated vasculitis such as Wegener’s granulomatosis, Churg-Strauss syndrome and microscopic polyangiitis. We report the case of a young female patient who developed severe AH necessitating orotracheal intubation and mechanic assisted ventilation with positive end expiratory pressure. Since no evidence of infection, malformation or blood dyscrasia was found, immediate therapy with glucocorticoids and cytotoxic drugs was started and a satisfactory control of the disease activity was achieved and has persisted for 24 months of follow-up. The clinical, laboratorial and histological data allowed establishing the diagnosis of microscopic polyangiitis.
vasculitis; alveolar hemorrhage; microscopic polyangiitis
