[Acute respiratory distress syndrome related to intra-alveolar hemorrhage revealing a vasculitis]

Rev Pneumol Clin. 2012 Oct;68(5):295-9. doi: 10.1016/j.pneumo.2012.04.002. Epub 2012 Jun 29.
[Article in French]

Abstract

Intra-alveolar hemorrhage (IAH) could be revealed by acute respiratory failure. The classic association of hemoptysis - anemia - radiological infiltrates is suggestive and has to be confirmed by broncho-alveolar lavage with Golde score. Etiologies included immune and non-immune diseases, with specific treatment for each. We report a case of IAH revealed by acute respiratory distress syndrome and anemia (3 g/dL), related to pulmonary and cerebral vasculitis without renal involvement. The patient was efficiently treated with corticosteroids and cyclophosphamide. This case highlights the critical role of BAL cytological analysis with Golde score, and the need for a rapid and accurate diagnosis in order to guide specific treatment. If histology is needed, renal biopsy even without renal involvement, or surgical lung biopsy is possible.

Publication types

  • Case Reports

MeSH terms

  • Bronchial Diseases / complications*
  • Bronchial Diseases / diagnosis
  • Bronchial Diseases / diagnostic imaging
  • Diagnosis, Differential
  • Female
  • Hemorrhage / complications*
  • Hemorrhage / diagnosis
  • Hemorrhage / diagnostic imaging
  • Humans
  • Middle Aged
  • Pulmonary Alveoli / pathology
  • Radiography, Thoracic
  • Respiratory Distress Syndrome / diagnosis
  • Respiratory Distress Syndrome / diagnostic imaging
  • Respiratory Distress Syndrome / etiology*
  • Vasculitis / complications*
  • Vasculitis / diagnosis
  • Vasculitis / diagnostic imaging