Clinical Findings in Ten Patients With Diffuse Alveolar Hemorrhage

DOI 3 Citations 25 References
  • Kakugawa Tomoyuki
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
  • Mukae Hiroshi
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
  • Kawabata Yuko
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
  • Kaida Hideyuki
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
  • Sakamoto Noriho
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
  • Kitamura Yuko
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
  • Yoshioka Sumako
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
  • Fujii Takeshi
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
  • Kadota Jun-ichi
    the Second Department of Internal Medicine, Oita Medical University, Japan
  • Kohno Shigeru
    The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan

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  • びまん性肺胞出血10例の検討

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Abstract

Purpose. The causes of diffuse alveolar hemorrhage (DAH) are various and DAH frequently worsens rapidly, so early diagnosis is crucial. In order to clarify the clinical features of DAH, we reviewed the DAH cases we encountered in the past 7 years in our department. Materials and Methods. The clinical features of 10 patients given a diagnosis of DAH between January 1996 and March 2002 in our department were analyzed. Results. Six were men, four were women and the average age was 53.6 years (range 28-75). The causes of DAH were as follows : idiopathic acute eosinophilic pneumonia (one case), drug induced acute eosinophilic pneumonia (one case), fibrosing nonspecific interstitial pneumonia (one case), chronic heart failure due to mitral valve regurgitation (one case), lymphangioleiomyomatosis (one case), inappropriate warfarization (one case), pulmonary amyloidosis (one case), antineutrophil cytoplasmic antibody associated vasculitides (one case), idiopathic alveolar hemosiderosis (two cases). Four cases were treated with pulse therapy with methylprednisolone and one case was treated with pulse therapy with methylprednisolone, cyclophosphamide and plasmapheresis. Three cases improved only by treatment for the original disease. Two cases improved apparently according to the natural course of the disease. Conclusion. The causes of DAH were so variegated, that it is quite difficult to make a definitive diagnosis. Performing BAL was useful for early diagnosis. Although pulse therapy with methylprednisolone and administration of immunosuppressive agents are common, the indications should be determined according to the original disease. (JJSB. 2003 ; 25 : 85-89)

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