Hemoptysis: A 10-Year Retrospective Study

Abstract

ABSTRACT. Background. Hemoptysis is uncommon in pediatric practice. We reviewed 10 years of experience with hemoptysis in a tertiary pediatric hospital to identify patient characteristics and predictors of mortality.Methods. Patients were divided into four age groups (0 to 5, 6 to 10, 11 to 20, and >20 years). Hemoptysis was defined as mild (<150 mL/day), large (150 to 400 mL/day), or massive (>400 mL/day). Fever was defined as 38.5°C.Results. A total of 228 patients (115 males and 113 females) with 246 episodes of hemoptysis were identified and grouped according to primary diagnosis. There were 149 patients in the cystic fibrosis (CF) group, 37 in the congenital heart disease (CHD) group, and 42 in the Other group. Age was significantly higher in the CF group compared with the CHD and Other groups. Length of stay was significantly prolonged in the CF group compared with the Other group. The overall mortality was 13%. After initial analysis, mortality predictors were age, amount of hemoptysis, receipt of blood products, and fever. After stratification, we found: 1) in the >20-year age group, there was a difference in mortality when comparing CF patients with CHD patients; 2) for patients who received blood products, there were differences in mortality in patients with CF, CHD, and Other diagnoses; 3) for patients who received blood, there were differences in mortality only for the 0-to 5-year age group; and 4) the amount of hemoptysis was predictive for mortality only in CHD patients.Conclusions. Hemoptysis presented in young adult CF patients and in adolescent CHD patients. Young adult CF patients with hemoptysis had a higher risk of mortality compared with young adult CHD patients.

Pulmonary Tuberculosis in a Child Presenting with Acute Hemoptysis

“…Hemoptysis is uncommon in pediatric patients. Coss-Bu et al 3 reviewed 228 children and young adults over a period of 10 years, and found that cystic fibrosis was the major cause of hemoptysis in 65%, various types of congenital heart diseases in 16%, and other causes, including infections, in the rest. Among other causes, they found tuberculosis in only two patients (0.9%).…”

“…Among other causes, they found tuberculosis in only two patients (0.9%). 3 Salazar et al found that 12% of definite pediatric pulmonary tuberculosis manifested with hemoptysis. 7 Although hemoptysis may be a presenting symptom of pulmonary tuberculosis in older children and adults, it is usually associated with other symptoms such as prolonged cough.…”

“…3 It commonly occurs with cystic fibrosis, bronchiectasis, cardiopulmonary anomalies, and respiratory tract infections. 3,4 Although tuberculosis is one underlying cause of hemoptysis, tuberculosis is more likely to present with other symptoms such as fever, anorexia, failure to gain weight, or unexplained lymphadenopathy. 5 We report on a young child who presented with sudden hemoptysis caused by tuberculosis.…”

Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis

“…2,6,7 In 1990s, cystic fibrosis and congenital heart diseases (mitral stenosis) were reported as predominant etiologic factors for hemoptysis. 8 Currently, various etiologies are suggested including idiopathic pulmonary hemosiderosis, pulmonary vascular malformation, pulmonary arteriovenous fistula, bronchiectasis, pulmonary tuberculosis, and lung tumors, with cystic fibrosis accounting for only 5% of cases. 9 Extrapulmonary bleeding, sometimes referred as pseudohemoptysis, is a common umbrella term for all types of hemorrhage not derived from the lungs or bronchial tubes and excluding hematemesis.…”

Hemoptysis in Children

“…Konjenital kalp hastalıkları (KKH) diğer bir hemoptizi nedenidir. Üçüncü basamak tedavi merkezlerinde gö-rülen tüm hemoptizi nedenlerinin %25'ini oluşturur [10]. KKH olan çocukların %4,5'i acil servise hemoptizi ile başvurur [11].…”