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Eur Respir J 2004; 23:954-956
Copyright ©ERS Journals Ltd 2004

A case of steroid responsive pulmonary hyalinising granuloma: complicated by deep venous thrombosis

K.M.A. O'Reilly1, J.A. Boscia1, K.L. Kaplan2 and P.J. Sime1

1 Dept of Medicine, Divisions of Pulmonary and Critical Care Medicine, and 2 Vascular Medicine, University of Rochester Medical Center, Rochester, New York, USA

CORRESPONDENCE: P.J. Sime, Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, 601 Elmwood Avenue (Box 692), Rochester, USA. Fax: 1 5852731114, E-mail: patricia_sime@urmc.rochester.edu

Keywords: Auto-antibodies, corticosteroids, deep venous thrombosis, lupus anticoagulant, pulmonary hyalinising granuloma

Received: September 10, 2003
Accepted January 5, 2004

Abstract

A case of pulmonary hyalinising granuloma (PHG) complicated by deep venous thrombosis (DVT) is presented.

The DVT was associated with the presence of a lupus anticoagulant. In the past PHG has been linked to various auto-antibodies, but to the best of the authors' knowledge, this is the first case reporting PHG in association with a lupus anticoagulant and clinically significant venous thrombosis. Historically, PHG has been regarded as poorly corticosteroid responsive. However, the patient in this case study responded dramatically to prednisone.

This case study suggests that in selected patients with pulmonary hyalinising granuloma experiencing disabling symptoms and worsening pulmonary function, a trial of corticosteroids may be warranted.






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Copyright © 2004 by the European Respiratory Society.