Work

Management and outcome of immune-mediated diffuse alveolar hemorrhage: a single centre case series

Year: 2025

Type: article

Abstract: Diffuse alveolar hemorrhage (DAH) is a clinical syndrome characterized by alveolar bleeding that can happen as a severe complication of immune-mediated diseases with a high mortality rate 1,2 .Treatment comprises supportive care and addressing the underlying disease.High-dose glucocorticoids (GC) and cyclophosphamide (CYC) or rituximab (RTX) remain the standard of care for immune-mediated DAH (IM-DAH) 2,3 .The role of intravenous immunoglobulin (IVIg) and plasma exchange (PLEX) is controversial 3,4 .Our aim is to describe the treatment approach and outcomes in IM-DAH in clinical practice.A retrospective single-centre observational study was conducted in patients admitted to a tertiary rheumatology centre between 2005 and 2023 with IM-DAH.Data were retrieved from medical records.A descriptive analysis was performed with IBM® SPSS® Statistics, version 27.0, and data are presented as absolute and relative frequencies.Twelve cases of IM-DAH were identified, corresponding to ten patients.Their demographics, clinical characteristics, and management are presented in Table I.IM-DAH was diagnosed by bronchoalveolar lavage (BAL) in nine cases.In three cases (one of them a relapse previously diagnosed with BAL), the diagnosis was made clinically, based on the presence of new pulmonary infiltrates and haemoptysis or a drop in haemoglobin without an alternative explanation.The median hospital stay was 17 days (IQR 27), with intensive care unit admission in seven cases and a median stay of 4 days (IQR 12).Half of the patients (n=5) had the diagnosis of systemic lupus erythematosus (SLE), three of them with secondary antiphospholipid syndrome (APS), and the other five had anti-neutrophil cytoplasmic antibodies

Source: ARP Rheumatology

DOI: 10.63032/ikpq3770

Authors: Catarina Abreu, Vanessa Fraga, Alice Morais de Castro, Sandra Sousa, Ana Catarina Duarte, Maria José Santos

Institutions: Hospital Garcia de Orta, Unidade Local de Saúde de Almada-Seixal

Language: English

Topic: Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4414580916