<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-2448</journal-id>
<journal-title><![CDATA[Acta Medica Colombiana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta Med Colomb]]></abbrev-journal-title>
<issn>0120-2448</issn>
<publisher>
<publisher-name><![CDATA[Asociacion Colombiana de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-24482019000200111</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hemorragia alveolar difusa secundaria a vasculitis asociada a ANCA. Recaída durante hemodiálisis]]></article-title>
<article-title xml:lang="en"><![CDATA[Diffuse alveolar hemorrhage secondary to ANCA-associated vasculitis. Relapse during hemodialysis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Contreras-Villamizar]]></surname>
<given-names><![CDATA[Kateir Mariel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Padilla]]></surname>
<given-names><![CDATA[Paola Karina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-González]]></surname>
<given-names><![CDATA[Camilo Alberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[Martha Patricia Rodríguez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Toro-Atara]]></surname>
<given-names><![CDATA[Jhonatan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Pontificia Universidad Javeriana Facultad de Medicina ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Pontificia Universidad Javeriana Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Bogotá, D.C. ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>44</volume>
<numero>2</numero>
<fpage>111</fpage>
<lpage>114</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-24482019000200111&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-24482019000200111&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-24482019000200111&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La hemorragia alveolar difusa (HAD) masiva es una complicación inusual de los pacientes con vasculitis ANCA, frecuentemente amenaza la vida y está asociada con una mortalidad de hasta el 100%. La información en la literatura acerca del tratamiento en casos refractarios y cuando el paciente se encuentra en diálisis es escasa. Se presenta el caso de un paciente con vasculitis p-ANCA con compromiso renal y pulmonar en el escenario de síndrome pulmón-riñón, con múltiples recaídas de hemorragia alveolar a pesar de tratamiento con corticoide, azatioprina, ciclofosfamida y terapia de recambio plasmático. Se instauró manejo con anticuerpo monoclonal anti CD20 e inmunoglobulina, logrando resolución del episodio de hemorragia alveolar y permaneciendo sin actividad. Se resalta la utilidad del rituximab como estrategia terapéutica en casos refractarios. (Acta Med Colomb 2019; 44: 111-114).]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Massive diffuse alveolar hemorrhage (DAH) is an unusual complication of patients with ANCA vasculitis that frequently threatens life and is associated with mortality up to 100%. In formation in the literature about treatment in refractory cases and when the patient is on dialysis is scarce. The case of a patient with p-ANCA vasculitis with renal and pulmonary involvement in the lung-kidney syndrome scenario, with multiple relapses of alveolar hemorrhage despite treatment with corticosteroid, azathioprine, cyclophosphamide and plasma exchange therapy is presented. Management with anti-CD20 monoclonal antibody and immunoglobulin was estab lished, achieving resolution of the episode of alveolar hemorrhage and remaining without activity. The usefulness of rituximab as a therapeutic strategy in refractory cases is highlighted. (Acta Med Colomb 2019; 44: 111-114).]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[hemodiálisis]]></kwd>
<kwd lng="es"><![CDATA[hemorragia alveolar difusa]]></kwd>
<kwd lng="es"><![CDATA[intercambio plasmático]]></kwd>
<kwd lng="es"><![CDATA[rituximab]]></kwd>
<kwd lng="es"><![CDATA[vasculitis asociada a anticuerpos citoplasmáticos antineutrófilos]]></kwd>
<kwd lng="en"><![CDATA[hemodialysis]]></kwd>
<kwd lng="en"><![CDATA[diffuse alveolar hemorrhage]]></kwd>
<kwd lng="en"><![CDATA[plasma exchange]]></kwd>
<kwd lng="en"><![CDATA[rituximab]]></kwd>
<kwd lng="en"><![CDATA[vasculitis associated with antineutrophil cytoplasmic antibodies]]></kwd>
</kwd-group>
</article-meta>
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