抄録
Alveolar hemorrhage may occur during an acute exacerbation of interstitial lung disease (AE-ILD) or may be caused by a negative pressure mechanism due to upper airway obstruction such as laryngospasm in the perioperative period. There have been no reports of negative pressure pulmonary hemorrhage (NPPH) due to laryngospasm without obvious invasive factors. We experienced a case of repeated NPPH due to idiopathic laryngospasm, resembling an AE-ILD. A 62-year-old woman developed multiple alveolar hemorrhages due to a sense of obstruction in the throat, followed by bloody sputum and dyspnea. She was considered to have an AE-ILD with Sjögren's syndrome and was treated with immunosuppressive therapy but had recurrent relapses. Bronchoscopy was performed under minimal anesthesia to elicit the cough reflex by vocal cord stimulation, and findings of internal rotation and complete occlusion of the vocal cords were confirmed. She was diagnosed as NPPH due to laryngospasm, and she has been treated with muscle relaxants without recurrence. NPPH due to laryngospasm can be a differential diagnosis as a cause of alveolar hemorrhage. By confirming the diagnosis through bronchoscopic examination of the larynx under minimal anesthesia, unnecessary immunosuppressive treatment for suspected AE-ILD can be avoided and appropriate preventive treatment can be provided.
