Bronchial Artery Embolization in Pediatric Pulmonary Hemorrhage: A Single-Center Experience

Zhao, Qiyi; Zhao, Lu; Wu, Lin; Lu, Ying; Chu, Chen; Wang, Li-Bo; Niu, Conway; Liu, Fang

doi:10.1016/j.jvir.2019.11.007

Cited by 7 publications

(9 citation statements)

References 34 publications

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“…Several studies have shown that BAE is successful in more than 90% of cases. However, recurrence of hemoptysis was noted in 20% to 40% of cases that required further BAE [ 5 , 13 , 14 ]. Most complications after BAE are minor and self-limiting.…”

Section: Discussionmentioning

confidence: 99%

Tranexamic Acid Use for Massive Hemoptysis in a Child: A Case Report

Mazi¹

2022

Cureus

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Massive hemoptysis is a rare life-threatening condition in children. Individuals with non-cystic fibrosis bronchiectasis may present with various degrees of hemoptysis. Therapeutic measures are mainly derived from studies involving adults or various case reports of children with cystic fibrosis. The standard management of massive hemoptysis is limited to invasive bronchoscopy, bronchial artery embolization, and surgical resection. Tranexamic acid (TXA) use is limited to non-massive hemoptysis or as an adjuvant and temporizing measure before definitive treatment. We report the potential use of TXA as an emergency treatment for massive hemoptysis in a 10-year-old boy with non-cystic fibrosis bronchiectasis and chronic infection. The use of systemic TXA (250 mg every eight hours for five days) successfully stopped active bleeding beginning from the first dose and altered the need for invasive interventions. Although he experienced another episode of massive hemoptysis because of pneumonia and pulmonary exacerbation, invasive measures were not required because he responded to systemic TXA immediately. Moreover, no further recurrence of hemoptysis was noted on cessation of TXA and throughout two years of regular follow-up. Therefore, TXA could be considered a non-invasive therapy for children with massive hemoptysis, especially in the absence of standard invasive therapies.

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Section: Discussionmentioning

confidence: 99%

Tranexamic Acid Use for Massive Hemoptysis in a Child: A Case Report

Mazi¹

2022

Cureus

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“…This method depends on the logic that the DAH in IPH could be secondary to anatomic abnormalities in the bronchial circulation leading to bland pulmonary hemorrhage. Zhao et al reported using BAE in a cohort of 41 children, 24 of whom were diagnosed with IPH 74 . The authors reported the identification of bronchial artery abnormalities (BAA) on angiogram on additional patients despite no CT evidence of BAA.…”

Section: Clinical Aspects In Iphmentioning

confidence: 99%

“…reported using BAE in a cohort of 41 children, 24 of whom were diagnosed with IPH. 74 The authors reported the identification of bronchial artery abnormalities (BAA) on angiogram on additional patients despite no CT evidence of BAA. Remarkably, there were angiographic abnormalities in all patients with IPH.…”

Section: Treatmentmentioning

confidence: 99%

“…Recently several experimental therapies have been attempted for pediatric IPH patients. These include mesenchymal stem cell (MSC) transplant, 47 bronchial artery embolization (BAE), 74 and liposteroid therapy 48 . Xu et al reported using bone marrow‐derived MSC in 10 children (3 boys and 7 girls) with IPH.…”

Section: Clinical Aspects In Iphmentioning

confidence: 99%

“…for pediatric IPH patients. These include mesenchymal stem cell (MSC) transplant, 47 bronchial artery embolization (BAE), 74 and liposteroid therapy. 48 The use of BAE is an innovative approach for the management of DAH in IPH.…”

Section: Treatmentmentioning

confidence: 99%

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Updates in idiopathic pulmonary hemosiderosis in 2022: A state of the art review

Saha

Aiman

Chong

et al. 2022

Pediatric Pulmonology

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This manuscript reports the recent advances in idiopathic pulmonary hemosiderosis (IPH), a rare cause of diffuse alveolar hemorrhage in children and adults. This narrative review of the literature summarizes different aspects of IPH, including proposed pathogenesis, patient demographics, clinical and radiological characteristics, treatment, and prognosis. Additionally, the association between Celiac Disease (CD) and IPH is carefully evaluated. IPH is a frequently misdiagnosed disease. The delay in the diagnosis of IPH is often significant but fortunately, appears to have decreased in recent years. IPH in adults and children have distinct demographic preferences. The autoantibodies are common in IPH but with a definite difference between the adult and pediatric populations. The definitive diagnosis of IPH requires lung biopsy and careful exclusion of all competing diagnoses, even with lung biopsy showing bland pulmonary hemorrhage. The presence of nonspecific inflammatory cells or lymphoid aggregates may suggest a secondary immunologic phenomenon and needs careful evaluation and follow-up. A substantial number of patients suffer from coexisting CD, also known as Lane−Hamilton syndrome (LHS), and all patients with IPH need to be evaluated for LHS by serology. Although strict gluten free diet can manage the majority of patients with LHS, other patients generally require immunosuppressive therapy. The corticosteroids are the backbone of IPH therapy. Recently utilized experimental treatment options include mesenchymal stem cell transplant, liposteroid and bronchial artery embolization. The immunosuppression should be adjusted to achieve optimal disease control. Patients may progress to endstage lung disease despite all measures, and lung transplantation may be the only viable option.

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