Diffuse alveolar hemorrhage: Difference between revisions
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Idiopathic small vessel vasculitis | Idiopathic small vessel vasculitis | ||
* Wegener's granulomatosis | * [[Wegener's granulomatosis]] | ||
* Churg-Straus syndrome | * Churg-Straus syndrome | ||
* Microscopic polyangitis | * Microscopic polyangitis | ||
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Primary immune complex-mediated vasculitis | Primary immune complex-mediated vasculitis | ||
* Goodpasture's syndrome | * Goodpasture's syndrome | ||
* Henoch-Schonlein purpura | * [[Henoch-Schonlein purpura]] | ||
Secondary vasculitis | Secondary vasculitis | ||
* Systemic lupus erythematosus | * [[Systemic lupus erythematosus]] | ||
* Rheumatoid arthritis | * [[Rheumatoid arthritis]] | ||
* Mixed connective tissue disease | * Mixed connective tissue disease | ||
* Polymyositis/Dermatomyositis | * [[Polymyositis]]/[[Dermatomyositis]] | ||
Acute lung transplant rejection<br /> | Acute [[lung transplant]] rejection<br /> | ||
Drug induced (ie. chemotherapy, amiodarone, propylthiouracil)<br /> | Drug induced (ie. chemotherapy, [[amiodarone]], propylthiouracil)<br /> | ||
ARDS<br /> | [[ARDS]]<br /> | ||
Coagulopathy<br /> | [[Coagulopathy]]<br /> | ||
Pulmonic veno-occlusive disease <br /> | Pulmonic veno-occlusive disease <br /> | ||
Mitral stenosis | [[Mitral stenosis]] | ||
===Diagnosis=== | ===Diagnosis=== | ||
Revision as of 16:39, 13 June 2016
Background
- Diffuse Alveolar Hemorrhage (DAH) is a life-threatening condition.
- It is a subset of Pulmonary hemorrhage involving the microcirculation involving alveolar microvasculature.
- Most commonly the result of systemic vasculitis. [1]
Clinical Features
- Hemoptysis
- Anemia
- Diffuse lung infiltrates
- Acute respiratory failure
Differential Diagnosis
Idiopathic small vessel vasculitis
- Wegener's granulomatosis
- Churg-Straus syndrome
- Microscopic polyangitis
Primary immune complex-mediated vasculitis
- Goodpasture's syndrome
- Henoch-Schonlein purpura
Secondary vasculitis
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Mixed connective tissue disease
- Polymyositis/Dermatomyositis
Acute lung transplant rejection
Drug induced (ie. chemotherapy, amiodarone, propylthiouracil)
Pulmonic veno-occlusive disease
Diagnosis
Management
General principles
- Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)
- IV corticosteroids - high dose Methylprednisolone Q6H[2]
- Bronchoscopy to obtain BAL and localize source of bleeding if localizable
- Management of Hemoptysis