Alveolar haemorrhage syndrome

Alveolar haemorrhage syndrome Alveolar hemorrhagic syndrome is characterized by the presence of a persistent or recurrent pulmonary hemorrhage. Diffuse alveolar haemorrhage syndrome is a diagnosis because it requires an independent and differential diagnosis requires a specific set of tests and treatments. Differential diagnosis is made with a wide range of diseases: autoimmune systemic vasculitis such as Goodpasture syndrome, pulmonary infection, exposure to toxic substances, reactions to drugs, bone marrow transplantation and organ, clotting disorders or diseases caused by anticoagulants, heart disease (mitral stenosis) pauciimune pulmonary vasculitis, idiopathic pulmonary hemosideroza.
Etiology
Vasculitis Pulmonary alveolar hemorrhage pauciimuna determine manifestation in people aged 18 to 35 years. Hemosideroza idiopathic pulmonary diffuse alveolar haemorrhage is a syndrome, whose cause is not known. The disease occurs mainly in children 10 years and dub is attributed to a defect in the alveoli, capillary endothelium (possibly due to an autoimmune disease). Some of these conditions can lead to glomerulonephritis, in which case the patient suffers from a reno-pulmonary syndrome.
Clinical

Milder forms of alveolar hemorrhagic syndrome manifests with dyspnoea, cough and fever. However, many patients may present with acute respiratory failure. Hemoptysis is a common symptom, but may be absent in one third of cases. Children with idiopathic pulmonary hemosideroza may have problems of physical development.
Diagnosis
The diagnosis of diffuse alveolar haemorrhage syndrome is often suggested by the outcome of chest radiography, which showed diffuse bilateral alveolar infiltrates.

To exclude glomerulonephritis and reno-pulmonary syndrome in the assumptions is necessary to conduct diagnostic tests of urine. Other tests to identify specific causes are: CBC, coagulation tests, blood platelet count, serology (antinuclear antibodies, anti-dsDNA, anti-GBM, ANCA). ANCA antibody titer is high in some cases of pulmonary vasculitis pauciimuna. The diagnosis of idiopathic pulmonary hemosideroza place by showing an iron deficiency anemia and macrophages in bronchoalveolar lavage with hemosiderin. To exclude glomerulonephritis and reno-pulmonary syndrome diagnosis is needed in making assumptions. Other tests to identify specific causes are: (antinuclear antibodies, anti-dsDNA, anti-GBM, ANCA). is high in some cases of pulmonary vasculitis pauciimuna. The diagnosis of idiopathic pulmonary hemosideroza is made by and to highlight any bronchoalveolar lavage.
Depending on clinical context, can perform other tests such as spirometry (lung function testing). Increased diffusion capacity for carbon monoxide due to increased intake or hemoglobin intraalveolara also indicate a hemorrhage. To exclude diganosticului mitral stenosis may be an echo. Bronchoalveolar lavage fluid reveals the presence of a hemorrhagic containing several Kir after harvesting. If bleeding remains uncertain etiology, lung biopsy is indicated.
Treatment and prognosis
Alveolar hemorrhagic syndrome and recurrent pulmonary fibrosis causes hemosideroza, both diseases appear when the trend ferritin agresagare the alveoli and cause toxic effects. Thanks poliarteritei microscopic, some patients with recurrent alveolar hemorrhage may develop chronic obstructive bronchopneumonia.
Treatment of hemorrhagic syndrome and etiologic silica is primarily based on corticosteroids and possibly cyclophosphamide for treatment of vasculitis, collagen disease and Goodpasture syndrome. Corticosteroids are used in the treatment of idiopathic pulmonary hemosiderozei. In patients unresponsive to immunosuppressive treatment can be given.