Diffuse alveolar hemorrhage - Revision history

Shank1020: /* Clinical Features */

2021-08-05T15:41:00Z

Clinical Features

← Revisión anterior		Revisión del 15:41 5 ago 2021
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	==Clinical Features==		==Clinical Features==
	*[[Hemoptysis]] ( may be initially absent in up 33% of DAH presentations <ref>Lara A, Schwarz M. Diffuse Alveolar Hemorrhage. Chest 2010. 137(5):1164-1171</ref>		*[[Hemoptysis]] (may be initially absent in up 33% of DAH presentations) <ref>Lara A, Schwarz M. Diffuse Alveolar Hemorrhage. Chest 2010. 137(5):1164-1171</ref>
	*[[Anemia]]		*[[Anemia]]
	*Diffuse lung infiltrates		*Diffuse lung infiltrates

ClaireLewis at 15:29, 12 October 2019

2019-10-12T15:29:39Z

← Revisión anterior		Revisión del 15:29 12 oct 2019
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	**[[Systemic lupus erythematosus]]		**[[Systemic lupus erythematosus]]
	**[[Rheumatoid arthritis]]		**[[Rheumatoid arthritis]]
	**Mixed connective tissue disease		**Mixed [[connective tissue disease]]
	**[[Polymyositis]]/[[Dermatomyositis]]		**[[Polymyositis]]/[[Dermatomyositis]]
	*Acute [[lung transplant]] rejection		*Acute [[lung transplant]] rejection
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	*Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)		*Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)
	*IV [[corticosteroids]] - high dose [[Corticosteroids\|Methylprednisolone]] Q6H<ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>		*IV [[corticosteroids]] - high dose [[Corticosteroids\|Methylprednisolone]] Q6H<ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>
	*Bronchoscopy to obtain BAL and localize source of bleeding if localizable		*Bronchoscopy to obtain BAL and localize/address source of bleeding if localizable
	*[[Hemoptysis\|Management of Hemoptysis]]		*[[Hemoptysis\|Management of Hemoptysis]]
			**Correct any [[coagulopathy]]
			**Consider nebulized [[TXA]] if massive<ref>Wand O, et al. Inhaled Tranexamic Acid for Hemoptysis Treatment: A Randomized Controlled Trial. Chest. DOI: https://doi.org/10.1016/j.chest.2018.09.026</ref>

	==Disposition==		==Disposition==

ClaireLewis at 21:24, 22 August 2019

2019-08-22T21:24:13Z

← Revisión anterior		Revisión del 21:24 22 ago 2019
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	*[[Anemia]]		*[[Anemia]]
	*Diffuse lung infiltrates		*Diffuse lung infiltrates
	*Acute hypoxemic respiratory failure		*Acute hypoxemic [[respiratory failure]]

	==Differential Diagnosis==		==Differential Diagnosis==
	*Idiopathic small vessel vasculitis		*Idiopathic small vessel vasculitis
	**[[Granulomatosis with polyangiitis]] (Wegener's)		**[[Granulomatosis with polyangiitis]] (Wegener's)
	**Churg-~~Straus~~ syndrome		**[[Churg-Strauss syndrome]]
	**Microscopic polyangitis		**Microscopic polyangitis
	*Primary immune complex-mediated vasculitis		*Primary immune complex-mediated vasculitis
	**Goodpasture's syndrome		**[[Goodpasture syndrome]]
	**[[Henoch-Schonlein purpura]]		**[[Henoch-Schonlein purpura]]
	*Secondary vasculitis		*Secondary vasculitis
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	==Evaluation==		==Evaluation==
	*Clinical suspicion with falling hematocrit		*Clinical suspicion with falling hematocrit
	*Radiographic imaging consistent with bilateral infiltration (CXR, CT) - can be patchy, focal or diffuse		*Radiographic imaging consistent with bilateral infiltration ([[CXR]], CT) - can be patchy, focal or diffuse
	*Bronchoscopy with BAL showing sequentially increasing RBC counts		*Bronchoscopy with BAL showing sequentially increasing RBC counts

	==Management==		==Management==
	*Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)		*Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)
	*IV corticosteroids - high dose [[Corticosteroids\|Methylprednisolone]] Q6H<ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>		*IV [[corticosteroids]] - high dose [[Corticosteroids\|Methylprednisolone]] Q6H<ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>
	*Bronchoscopy to obtain BAL and localize source of bleeding if localizable		*Bronchoscopy to obtain BAL and localize source of bleeding if localizable
	*[[Hemoptysis\|Management of Hemoptysis]]		*[[Hemoptysis\|Management of Hemoptysis]]
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	*[[Hemoptysis]]		*[[Hemoptysis]]

	==~~Exteernal~~ Links==		==External Links==
	[http://lifeinthefastlane.com/ccc/diffuse-alveolar-haemorrhage/ Life in the Fast Lane: Diffuse Alveolar Hemorrhage]		[http://lifeinthefastlane.com/ccc/diffuse-alveolar-haemorrhage/ Life in the Fast Lane: Diffuse Alveolar Hemorrhage]

ClaireLewis: /* Differential Diagnosis */

2016-11-14T01:14:54Z

Differential Diagnosis

← Revisión anterior		Revisión del 01:14 14 nov 2016
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	**[[Polymyositis]]/[[Dermatomyositis]]		**[[Polymyositis]]/[[Dermatomyositis]]
	*Acute [[lung transplant]] rejection		*Acute [[lung transplant]] rejection
	*Drug induced (ie. chemotherapy, [[amiodarone]], propylthiouracil)		*Drug induced (ie. chemotherapy, [[amiodarone]], [[propylthiouracil]])
	*[[ARDS]]		*[[ARDS]]
	*Multilobar [[Pneumonia]]		*Multilobar [[Pneumonia]]

Neil.m.young at 11:30, 23 July 2016

2016-07-23T11:30:39Z

← Revisión anterior		Revisión del 11:30 23 jul 2016
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	==Background==		==Background==
	*Diffuse Alveolar Hemorrhage (DAH) is a life-threatening condition.		*Diffuse Alveolar Hemorrhage (DAH) is a life-threatening condition
	*It is a subset of Pulmonary hemorrhage involving the microcirculation involving alveolar microvasculature.		*It is a subset of Pulmonary hemorrhage involving the microcirculation involving alveolar microvasculature
	*Most commonly the result of systemic vasculitis. <ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>		*Most commonly the result of systemic vasculitis <ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>

	==Clinical Features==		==Clinical Features==
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	*[[Mitral stenosis]]		*[[Mitral stenosis]]

	==~~Diagnosis~~==		==Evaluation==
	#Clinical suspicion with falling hematocrit		*Clinical suspicion with falling hematocrit
	#Radiographic imaging consistent with bilateral infiltration (CXR, CT) - can be patchy, focal or diffuse		*Radiographic imaging consistent with bilateral infiltration (CXR, CT) - can be patchy, focal or diffuse
	#Bronchoscopy with BAL showing sequentially increasing RBC counts		*Bronchoscopy with BAL showing sequentially increasing RBC counts

	==Management==		==Management==
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	==Disposition==		==Disposition==
			*Typically requires upper level of care

	==See Also==		==See Also==
			*[[Hemoptysis]]

			==Exteernal Links==
			[http://lifeinthefastlane.com/ccc/diffuse-alveolar-haemorrhage/ Life in the Fast Lane: Diffuse Alveolar Hemorrhage]

	==References==		==References==

ClaireLewis: /* Differential Diagnosis */

2016-07-19T03:28:31Z

Differential Diagnosis

← Revisión anterior		Revisión del 03:28 19 jul 2016
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Idiopathic small vessel vasculitis		*Idiopathic small vessel vasculitis
	**[[Wegener's ~~granulomatosis]]~~		**[[Granulomatosis with polyangiitis]] (Wegener's)
	**Churg-Straus syndrome		**Churg-Straus syndrome
	**Microscopic polyangitis		**Microscopic polyangitis

Neil.m.young: Text replacement - "* " to "*"

2016-07-05T15:27:27Z

Text replacement - "* " to "*"

← Revisión anterior		Revisión del 15:27 5 jul 2016
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	==Background==		==Background==
	* Diffuse Alveolar Hemorrhage (DAH) is a life-threatening condition.		*Diffuse Alveolar Hemorrhage (DAH) is a life-threatening condition.
	* It is a subset of Pulmonary hemorrhage involving the microcirculation involving alveolar microvasculature.		*It is a subset of Pulmonary hemorrhage involving the microcirculation involving alveolar microvasculature.
	* Most commonly the result of systemic vasculitis. <ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>		*Most commonly the result of systemic vasculitis. <ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>

	==Clinical Features==		==Clinical Features==
	* [[Hemoptysis]] ( may be initially absent in up 33% of DAH presentations <ref>Lara A, Schwarz M. Diffuse Alveolar Hemorrhage. Chest 2010. 137(5):1164-1171</ref>		*[[Hemoptysis]] ( may be initially absent in up 33% of DAH presentations <ref>Lara A, Schwarz M. Diffuse Alveolar Hemorrhage. Chest 2010. 137(5):1164-1171</ref>
	* [[Anemia]]		*[[Anemia]]
	* Diffuse lung infiltrates		*Diffuse lung infiltrates
	* Acute hypoxemic respiratory failure		*Acute hypoxemic respiratory failure

	==Differential Diagnosis==		==Differential Diagnosis==
	*Idiopathic small vessel vasculitis		*Idiopathic small vessel vasculitis
	** [[Wegener's granulomatosis]]		**[[Wegener's granulomatosis]]
	** Churg-Straus syndrome		**Churg-Straus syndrome
	** Microscopic polyangitis		**Microscopic polyangitis
	*Primary immune complex-mediated vasculitis		*Primary immune complex-mediated vasculitis
	** Goodpasture's syndrome		**Goodpasture's syndrome
	** [[Henoch-Schonlein purpura]]		**[[Henoch-Schonlein purpura]]
	*Secondary vasculitis		*Secondary vasculitis
	** [[Systemic lupus erythematosus]]		**[[Systemic lupus erythematosus]]
	** [[Rheumatoid arthritis]]		**[[Rheumatoid arthritis]]
	** Mixed connective tissue disease		**Mixed connective tissue disease
	** [[Polymyositis]]/[[Dermatomyositis]]		**[[Polymyositis]]/[[Dermatomyositis]]
	*Acute [[lung transplant]] rejection		*Acute [[lung transplant]] rejection
	*Drug induced (ie. chemotherapy, [[amiodarone]], propylthiouracil)		*Drug induced (ie. chemotherapy, [[amiodarone]], propylthiouracil)
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	==Management==		==Management==
	* Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)		*Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)
	* IV corticosteroids - high dose [[Corticosteroids\|Methylprednisolone]] Q6H<ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>		*IV corticosteroids - high dose [[Corticosteroids\|Methylprednisolone]] Q6H<ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>
	* Bronchoscopy to obtain BAL and localize source of bleeding if localizable		*Bronchoscopy to obtain BAL and localize source of bleeding if localizable
	* [[Hemoptysis\|Management of Hemoptysis]]		*[[Hemoptysis\|Management of Hemoptysis]]

	==Disposition==		==Disposition==

Neil.m.young: Text replacement - "# " to "#"

2016-07-05T07:52:13Z

Text replacement - "# " to "#"

← Revisión anterior		Revisión del 07:52 5 jul 2016
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	==Diagnosis==		==Diagnosis==
	# Clinical suspicion with falling hematocrit		#Clinical suspicion with falling hematocrit
	# Radiographic imaging consistent with bilateral infiltration (CXR, CT) - can be patchy, focal or diffuse		#Radiographic imaging consistent with bilateral infiltration (CXR, CT) - can be patchy, focal or diffuse
	# Bronchoscopy with BAL showing sequentially increasing RBC counts		#Bronchoscopy with BAL showing sequentially increasing RBC counts

	==Management==		==Management==

Neil.m.young: /* References */

2016-06-26T15:28:39Z

References

← Revisión anterior		Revisión del 15:28 26 jun 2016
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	==References==		==References==
	<references/>		<references/>

			[[Category:Pulmonary]]

Rossdonaldson1: /* Management */

2016-06-13T19:53:33Z

Management

← Revisión anterior		Revisión del 19:53 13 jun 2016
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	==Management==		==Management==
	~~General principles~~
	* Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)		* Airway stabilization if large volume hemoptysis or problems with oxygenation/ventilation (>8.0 ETT preferable)
	* IV corticosteroids - high dose [[Corticosteroids\|Methylprednisolone]] Q6H<ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>		* IV corticosteroids - high dose [[Corticosteroids\|Methylprednisolone]] Q6H<ref>Park M. Diffuse Alveolar Hemorrhage. Tuberc Resp Dis (Seoul) 2013. 74(4):151-162</ref>