Recurrent hemoptysis and lung ground-glass opacity in a 36-year-old female

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Case description

We describe a case of catamenial hemoptysis secondary to thoracic endometriosis syndrome in a 36-year-old woman who presented with moderate-volume hemoptysis and a right upper lobe (RUL) infiltrate visible on chest x-ray, which occurred on the first day of her menstrual cycle. She had been experiencing a metallic taste during her periods for the past 3 months. The following month, on the first day of her menses she again experienced significant hemoptysis and a computed tomography of the chest performed at this time showed dense area of ground glass change in her RUL, consistent with pulmonary hemorrhage. Bronchoscopy found mild clotting and old blood in the RUL, and endobronchial biopsy confirmed subepithelial hemorrhage. Blood tests showed normal coagulation, platelet count, and negative results for vasculitis and connective tissue diseases. This pattern of symptoms persisted for the following 6 months. The case was discussed at a multidisciplinary meeting, where it was decided that the clinical presentation, radiological findings, and timing of symptoms are consistent with catamenial hemoptysis, likely associated with endobronchial endometriosis. The patient’s treatment has been complicated, as she wished to conceive; theferore, she was unwilling to commence hormonal treatment at this time. However, counselling has been provided regarding the potential dangers of more significant hemoptysis and the patient has been reviewed by a consultant obstetrician.

About Best Case Report Contest 2024

Young Talents in Internal Medicine World Contest—previously Best Case Report Contest—is a contest for internal medicine specialists or trainees in internal medicine up to 35 years of age. Every year the most engaging submissions from around the world are presented by authors during a special session at the McMaster International Review Conference of Internal Medicine (MIRCIM). Visit youngtalents.one to learn more.

To browse all abstracts from Best Case Report Contest 2024, visit Polish Archives of Internal Medicine.