Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive dyspnea, non-productive cough, and recurrent hemoptysis. Symptoms are associated with constitutional signs including low-grade fever, fatigue, and unintended weight loss. No history of systemic vasculitis symptoms (e.g., arthralgia, rash, or hematuria) reported. Denies recent travel, occupational exposures, or smoking history.
Clinical Examination Findings
Vitals: Tachypnea and resting tachycardia noted; SpO2 stable on room air. Pulmonary: Bilateral diffuse fine crackles on auscultation, predominantly in lower lung fields. Cardiac: Regular rhythm, no murmurs or signs of right heart failure. Skin: No palpable purpura or vasculitic lesions. Extremities: No peripheral edema or clubbing.
Treatment Protocol
Initiate high-dose systemic corticosteroids (e.g., IV methylprednisolone followed by oral prednisone taper). Consider immunosuppressive therapy (e.g., cyclophosphamide or rituximab) based on disease severity and response. Monitor CBC, inflammatory markers (ESR/CRP), and serial chest imaging. Prophylaxis for Pneumocystis jirovecii pneumonia (PJP) indicated during intensive immunosuppression.