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Vol. 6. Issue 4.
Pages 196-198 (July - August 2010)
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Vol. 6. Issue 4.
Pages 196-198 (July - August 2010)
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Diffuse alveolar hemorrhage: Causes and outcomes in a referral center
Hemorragia alveolar difusa: causas y desenlaces en un instituto de tercer nivel
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Ivette Buendía-Roldána, Carmen Navarroa, Jorge Rojas-Serranob,
Corresponding author
jrojas@iner.gob.mx

Corresponding author.
a Instituto Nacional de Enfermedades Respiratorias Dr. Ismael Cosio Villegas, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico
b Servicio Clínico de Enfermedades Intersticiales del Pulmón, Instituto Nacional de Enfermedades Respiratorias Dr. Ismael Cosio Villegas, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico
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Abstract
Objective

To identify the most common causes of diffuse alveolar hemorrhage (DAH) and the evolution of cases during hospitalization.

Patients and methods

A review of cases diagnosed with DAH; the diagnoses were classified according to existing criteria and the progression of the cases was determined.

Results

We identified 17 cases of DAH, with the leading cause being ANCA associated vasculitis (41% of cases), followed by cases secondary to drugs (18%). In 35% of the cases, there was a failure in identifying an etiology. Six patients died (35%), the only factor associated with mortality was male gender 5/6 vs 3/11, P=.05.

Conclusions

The most frequent cause of alveolar hemorrhage was ANCA associated vasculitis. The mortality in DAH is about 35%, males seem to have a worse prognosis.

Keywords:
Diffuse alveolar hemorrhage
Vasculitis associated with antibodies anticitoplasm of neutrophils
Wegener's granulomatosis
Antibodies anticitoplasm of neutrophils
Microscopic polyangiitis
Resumen
Objetivo

Identificar las causas más frecuentes de hemorragia alveolar difusa (HAD) y conocer la evolución de los casos durante su hospitalización.

Pacientes y método

Revisión de expedientes con diagnóstico de HAD. Se clasificaron los diagnósticos de acuerdo con los criterios vigentes y se determinó la evolución.

Resultados

Se identificaron 17 casos de HAD, la principal causa fueron las vasculitis asociadas a ANCA (el 41% de los casos) seguida de las secundarias a drogas (el 18% de los casos). En un 35% no se logró identificar una etiología. Seis pacientes fallecieron (35%), el único factor asociado a mortalidad fue el sexo masculino (5/6 vs.− 3/11; p=0,05).

Conclusiones

La causa más frecuente de hemorragia alveolar son las vasculitis asociadas a ANCA, la mortalidad de la HAD es del 35% y los hombres parecen tener peor pronóstico.

Palabras clave:
Hemorragia alveolar difusa
Vasculitis asociadas a anticuerpos anticitoplasma de neutrófilos
Granulomatosis de Wegener
Anticuerpos anticitoplasma de neutrófilos
Poliangeítis microscópica
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Copyright © 2010. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
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