PMC4018244_01
Initial chest tomography.
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A CT scan of chest with contrast was performed and showed bilateral pulmonary consolidations and interstitial ground-glass densities with peripheral predominance without abnormally enlarged hilar or mediastinal adenopathy (Figure 1).
Bronchoscopy: Gross-hemorrhagic features in sequential samples and hyperemic mucosa. Micro-hemosiderin-filled macrophages.
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Fiber-optic bronchoscopy was performed the next day and findings were consisted with hyperemic inflammatory changes of airway mucosa associated with bloody secretions (Figure 2).
Pulmonary function test: FVC 61% of pred, FEV1 67% of pred, FEV1/FVC ratio of 94% of pred, TLC 54% of pred, and DLCO 121% of pred.
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The pulmonary function test showed a moderately restrictive ventilatory impairment (TLC 54% of predicted with FEV1 67% of predicted) with normal gas transfer (DLCO 121% of predicted) (Figure 3).
Chest tomography after treatment with IV methylprednisolone.
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While on treatment, the patient had a favorable response, with gradual clinical and radiographic improvement (Figure 4).