alveolar hemorrhage
Jump to navigation
Jump to search
Etiology
- immunologically mediated
- direct chemical or toxic injury
- toxic or chemical inhalation
- trimellitic anhydride
- pharmaceutical agents
- physical trauma - pulmonary contusion
- increased pulmonary capillary pressure
- complication of lymphangiography
- pulmonary lymphangioleiomyomatosis (uncommon)
- pulmonary vaso-occlusive disease
- associated with history of heavy smoking
- associated with bone marrow transplantation[2]
Pathology
- disruption of pulmonary capillary lining
- immunological & chemical mechanisms, trauma & increased pulmonary capillary pressure may contribute
- hemosiderin-laden macrophages
Clinical manifestations
- severity of symptoms dependent upon extent & acuteness of hemorrhage
- dyspnea
- anemia
- hemoptysis
- may be hematuria if associated with pulmonary-renal syndrome
- may be evidence of vasculitis
Laboratory
(frequent findings)
- complete blood count (CBC)
- thrombocytopenia (< 50,000/mm3)
- anemia
- coagulopathy
- serum creatinine > 2.5 mg/dL
Diagnostic procedures
- bronchoalveolar lavage
- hemosiderin-laden macrophages comprise > 20% of recovered alveolar macrophages
Complications
- potentially fatal
Management
- cyclophosphamide may be of marginal benefit[3]
More general terms
Additional terms
- bronchoalveolar lavage (BAL)
- glomerulonephritis (GN, nephritic syndrome)
- Goodpasture's syndrome
- idiopathic pulmonary hemosiderosis (hemorrhage)
- left ventricular failure
- mitral stenosis (MS)
- pulmonary alveolus
- systemic lupus erythematosus
- trimellitic anhydride
References
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 784-86
- ↑ 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 14, 17 American College of Physicians, Philadelphia 2006, 2015
- ↑ 3.0 3.1 Martinez-Martinez MU, Abud-Mendoza C. Predictors of mortality in diffuse alveolar haemorrhage associated with systemic lupus erythematosus. Lupus. 2011 May;20(6):568-74 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21558137
- ↑ Lara AR, Schwarz MI. Diffuse alveolar hemorrhage. Chest. 2010 May;137(5):1164-71. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20442117 Review.