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Recurrent haemoptysis with anaemia in a 16 year old man
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Diffuse alveolar haemorrhage (DAH)—secondary to idiopathic pulmonary haemosiderosis (IPH)
Haemoptysis is usually caused by focal disorders of the airways or lung parenchyma. The most common causes are bronchiectasis, pneumonia, lung malignancies, and tuberculosis.1 On rare occasions, the haemoptysis may be caused by diffuse alveolar haemorrhage.1 In this patient, recurrent haemoptysis, iron deficiency anaemia, bilateral parenchymal opacities, and haemosiderin laden macrophages in bronchoalveolar lavage point towards diffuse alveolar haemorrhage.
DAH is a rare syndrome that occurs mostly in association with systemic autoimmune diseases. It is commonly associated with ANCA associated vasculitides, connective tissue disorders, or antibasement membrane antibody syndromes.1 DAH may be caused by microscopic polyangitis or Wegener’s granulomatosis (pauci-immune pulmonary-renal vasculitis).2 These disorders have few or no immune deposits and as mentioned above are associated with ANCA (perinuclear or cytoplasmic respectively) and also have multi-system involvement. Isolated pauci-immune pulmonary capillaritis is a small vessel vasculitis of unknown aetiology with or
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- Recurrent haemoptysis with anaemia in a 16 year old man
- D Chaudhry, B N S Prasad, R Khanna, and U Singh
Postgrad. Med. J. 2005 81: e15.[Extract] [Full Text] [PDF]
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