Diffuse Alveolar Haemorrhage Complicated by Pulmonary Embolism—Problems with Treatment

Abstract

Diffuse alveolar haemorrhage (DAH) refers to a clinical syndrome resulting from injury of the alveolar capillaries, arterioles and venules leading to red blood cel accumulation in the distal air spaces. The conditions associated with DAH and underlying disease determine the prognosis and the treatment regimen. The coexistence of DAH with venous thromboembolism (VTE) is a seroius problem for clinicians and poses a challenge in the therapeutic management. We describe a young patient who developed massive DAH in the course of anti-glomerular basement membrane (anti-GBM) disease (formerly called Goodpasture's syndrome) complicated by pulmonary embolism (PE).

A Rare Etiology of Diffuse Pulmonary Hemorrhage

“…Diffuse alveolar hemorrhage (DAH) refers to a distinct subset of pulmonary hemorrhage with widespread bleeding into alveoli, presumably because of injury to lung microcirculation [1]. DAH can occur in many clinical settings including vasculitides, autoimmune and coagulation disorders, and infections.…”

Coexistence of Diffuse Alveolar Hemorrhage and Pulmonary Thromboembolism

“…DAH and PTE represent complex situations that are extraordinarily crucial because it is difficult to select whether anticoagulation or hemostasis is appropriate (1). In a pediatric case series from the United States elective anticoagulation therapy was selected for two patients with granulomatosis with polyangiitis with concurrent DAH and PTE (2).…”