TY - JOUR AU - Dhungana, Ashesh AU - Shrestha, Prajowl PY - 2019/12/17 Y2 - 2024/03/29 TI - Diffuse Alveolar Haemorrhage: A Single Centre Experience JF - Nepalese Medical Journal JA - Nep. Med. J. VL - 2 IS - 2 SE - Original Articles DO - 10.3126/nmj.v2i2.25828 UR - https://www.nepjol.info/index.php/nmj/article/view/25828 SP - 229-233 AB - <p class="Normal1" style="text-align: justify; line-height: 200%;"><strong>Introduction:</strong> Diffuse alveolar hemorrhage results from an accumulation of red blood cells&nbsp;into the alveolar space. Symptoms of alveolar hemorrhage are dyspnea, hemoptysis, anemia,&nbsp;diffuse pulmonary infiltrates and hypoxemic respiratory failure. Diagnosis is established by&nbsp;bronchoalveolar lavage and treatment includes a combination of high dose systemic corticosteroids,&nbsp;immunosuppressant and plasma exchange. The aim of this study is to evaluate the clinical radiological&nbsp;profile and laboratory findings and utility of bronchoalveolar lavage in the diagnosis&nbsp;of diffuse alveolar hemorrhage.<br><strong>Materials and Methods:</strong> In a retrospective review between February 2017 and December 2017,&nbsp;medical records of patients with a diagnosis of diffuse alveolar hemorrhage presenting at the&nbsp;National Academy of Medical Sciences, Kathmandu, Nepal, were analyzed. Clinical, radiology and&nbsp;laboratory results along with bronchoalveolar lavage results were extracted. Treatment received&nbsp;and clinical responses were evaluated.<br><strong>Results:</strong> A total of five patients were diagnosed to have diffuse alveolar hemorrhage based on&nbsp;bronchoalveolar lavage analysis. Three had hemorrhage secondary to Antineutrophil Cytoplasmic&nbsp;Antibody associated vasculitis, one had Systemic Lupus Erythematosus and the other Idiopathic&nbsp;Pulmonary Hemosiderosis. Renal involvement was present in three patients. All patients received systemic corticosteroids, three received Cyclophosphamide and one Rituximab for remission&nbsp;induction. Plasma exchange was done in two patients with severe hypoxemia. Of the five patients,&nbsp;four improved whereas one died.<br><strong>Conclusions:</strong> Diffuse alveolar hemorrhage presents with non-specific symptoms. Bronchoalveolar lavage is extremely&nbsp;useful to establish the diagnosis and exclude infections. Early initiation of immunosuppressant&nbsp;prevents respiratory failure and death.</p> ER -