Haemoptysis & dyspnoea

A previously healthy 21-year-old young woman presented with worsening dyspnoea and haemoptysis. X-ray and CT scan for chest region were done. There was no other organ system involvement, in particular, no evidence of renal involvement. Raised anti myeloperoxidases were found. The patient rapidly deteriorated with worsening respiratory failure despite invasive mechanical ventilation and required extracorporeal membrane oxygenation (ECMO). This maintained the patient long enough to allow aggressive therapy in the form of immunosuppression and plasma exchange.