Diffuse pulmonary hemorrhage is one of the conditions in the differential of
acute diffuse alveolar pattern on CXR.
- Patients present with acute onset of shortness of breath and
- Hemoptysis may or may not be present.
- Chest x-ray shows diffuse alveolar pulmonary infiltrates.
- tachypnea with bilateral crackles can be heard on physical exam.
- Blood gases show hypoxia with widened A-a gradient and alveolar
Multiple etiologies can give rise to pulmonary hemorrhage. Following are the
- Goodpasture's syndrome
- Wegener's granulomatosis
- Systemic lupus erythematosis
- Idiopathic pulmonary hemorrhage
Alveolar spaces are filled with blood. Lung is heavy and feels consolidated.
rest of the findings will depend on the etiology.
- Constellation of hemoptysis, diffuse alveolar infiltrates on CXR, unexplained
drop in hemoglobin usually raises suspicion for pulmonary hemorrhage.
- If PFT can be done, increase in diffusion capacity can be seen
due to sequestration of blood in lungs.
- Bronchoalveolar alveolar lavage will show RBC's and Iron stain is
positive in macrophages.
- Supportive care.
- Appropriate therapy based on the etiology.