PT  - JOURNAL ARTICLE
AU  - Natasa Savic
AU  - Predrag Minic
AU  - Milan Rodic
TI  - Unusual cause of pulmonary haemorrhage in adolescent
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P1249
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P1249.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P1249.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - We present a case of 14-year old, previously healthy girl with recurrent cough and hemoptysis. Chest X-ray showed round right lower lobe infiltration, she received antibiotics, but this finding persisted.Laboratory markers of inflammation, tests for tuberculosis and sarcoidosis were negative. Initial flexible bronchoscopy did not detect anatomic abnormalities nor site of active pulmonary hemorrhage. Chest MRI ruled out arteriovenous malformation or pulmonary sequestration. Various antibodies: pANCA, cANCA, anti-MPO, anti-PR3, anti-dsDNA, ANA were negative. The last episode of pulmonary hemorrhage was profuse and repeated flexible bronchoscopy revealed the presence of foreign body very laterally in right lower lobe. It was successfully removed by wire basket and corresponded to wall barley grass (Hordeum murinum).She received antibiotics and corticosteroid treatment and is symptom free, with normal chest X-ray and finding on physical examination. Conclusion: Occult foreign body in respiratory tract should be suspected in all patients with repeated respiratory symptoms, no matter of age. Bronchoscopic examination should be performed sometimes several times before diagnosis is established.