Clinical Analysis of 17 Patients with DiffuseAlveolar Hemorrhage_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 XIN Qinghong ¹ , ZHANGWenbo ² , LI Jicheng ¹ , WEI Juan ¹

Department of Respiratory Medicine, General Hospital of Beijing Military Area.Beijing, 100700, ChinaCorresponding Author: XIN Qing-hong, E-mail: xinqh1@ 126. com;

Corresponding author：

XIN Qinghong, Email: xinqh1@126.com

Keywords：

Diffuse alveolar hemorrhage; Diagnosis; ; Treatment

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Objetive To investigate the clinical characteristics, diagnosis, and treatment for diffuse alveolar hemorrhage. Methods The clinical data of 17 patients admitted to respiratory ICU with diffuse alveolar hemorrhage from July 1998 to May 2008 were reviewed. Results In the 17 cases, Wegener granulomatosis accounted for 6 cases, microscopic polyangiitis for 3 cases, systemic lupus erythematosis for 4 cases,mitral stenosis for 2 cases, and idiopathic pulmonary hemosiderosis for 1 cases. Clinical presentations included fever ( 76. 4% ) , hemoptysis( 47% ) , anaemia ( 100% ) , dyspnea ( 100% ) , hypoxaemia ( 100% ) ,and elevated total count of white blood cells ( 76. 4% ) . The titer of antineutrophil cytoplasmic antibody ( c-ANCA, p-ANCA) was 1∶( 46. 0 ±3. 7) , 1 ∶( 108. 0 ±16. 1) , respectively. Hemoglobin was ( 78. 0 ±
2. 4) g/L. Bronchoalveolar lavage fluid presented with blood accounted for 35. 3% . Siderophages was found in all cases. Computed tomography showed areas of consolidation interspersed with areas of ground-glass attenuation and reticular interstitial opacities. Mortality was 29. 4% . Conclusions Diffuse alveolar hemorrhage is an acute life-threatening event. The clinical presentations of hemoptysis, dyspnea, and anaemia, and chest imaging studies provide clues to diagnosis of diffuse alveolar hemorrhage. Corticosteroids and immunosuppressive agents have proven effective in diffuse alveolar hemorrhage.

Citation： XIN Qinghong,ZHANGWenbo,LI Jicheng,WEI Juan. Clinical Analysis of 17 Patients with DiffuseAlveolar Hemorrhage. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(6): 624-626. doi: Copy

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1. Leatherman JW. Immune alveolar hemorrhage. Chest,1987, 9:891-897.
2. 侯显明. 肺泡弥漫性出血. 临床内科杂志, 2003 , 20: 285-287.
3. Ioachimescu OC, Stoller JK. Diffuse alveolar hemorrhage: diagnosing it and finding the cause. Cleve Clin J Med,2008, 75: 258-280.
4. Travis WD, Colby TV, Lombard C, et al. A clinicopathologic study of 34 cases diffuse pulmonary hemorrhage with lung biopsy confirmation. Am J Surg Pathol, 1990, 14: 1112-1125.
5. Jennings CA, King TE, Tuder R, et al. Diffuse alveolar hemorrhage with underlying isolated puaciimmune pulmonary capillaritis. Am J Respi Crit Care Med, 1997, 155: 1101-1109.
6. Dweik AR, Stoller JK. Role of bronchoscopy in massive hemoptysis.Cli Chest Med, 1999, 20 : 89-105.
7. Rolla G, Heffler E, Bergia R, et al. Exhaled NO in diffuse alveolar hemorrhage. Thorax, 2005 , 60 : 614-615.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical Analysis of 17 Patients with DiffuseAlveolar Hemorrhage

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