TY - JOUR T1 - Proteinuria, pancytopenia and hypoxaemic respiratory failure in a 28-year-old female JF - European Respiratory Journal JO - Eur Respir J SP - 452 LP - 455 DO - 10.1183/09031936.06.00003106 VL - 28 IS - 2 AU - W. Berjaoui AU - N. Dean AU - N. Dahle Y1 - 2006/08/01 UR - http://erj.ersjournals.com/content/28/2/452.abstract N2 - A previously healthy 28-yr-old Caucasian female presented to the emergency department with a 1-week history of generalised body swelling that was followed by pleuritic chest pain radiating to the patient’s back. She had mild shortness of breath, cough and palpitations, but no fever, chills, nausea, vomiting or diarrhoea. No medications were taken except oral contraceptives. She denied any history of tobacco or alcohol use, recent travel or sick contacts. The patient’s vital signs were as follows: 1) blood pressure 135/94 mmHg; 2) body temperature 39.4°C; 3) respiratory rate 16 breaths·min-1; 4) pulse 105 beats·min-1; and 5) oxygen saturation 95%, while breathing room air. Her physical examination was remarkable for decreased breath sounds diffuse with minimal crackles, as well as facial swelling and pitting oedema of the lower extremities. Pertinent laboratory results of the blood tests performed on admission are shown in table 1⇓.View this table:In this windowIn a new windowTable 1— Laboratory results of the blood tests After significant respiratory distress, requiring noninvasive positive pressure ventilation, the patient was admitted to the intensive care unit and was started empirically on i.v. ceftriaxone, azithromycin and furosamide. Over the next few days, she remained febrile with worsening hypoxaemia. Her white blood cell count dropped to 2.2×109 cells·L-1 with a haemoglobin level of 90 g·L-1 and platelet count of 82×109 cells·L-1. … ER -