Acute onset of Wegener's granulomatosis and diffuse alveolar hemorrhage treated successfully by extracorporeal membrane oxygenation.

Wegener's granulomatosis is a necrotizing granulomatous vasculitis involving the upper airway, lungs, and kidneys. Diffuse alveolar hemorrhage is a rare and life-threatening presentation of Wegener's granulomatosis. We report on a previously healthy 13-yr-old boy who presented with fulminant pulmonary hemorrhage leading to acute respiratory distress syndrome and was found to have Wegener's granulomatosis. The diagnosis was based on clinical, radiologic, serologic, and histologic manifestations. The therapeutic challenges and the modalities of support to sustain life until clinical remission are presented.