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DIFFUSE ALVEOLAR HAEMORRHAGE

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DIFFUSE ALVEOLAR HAEMORRHAGE

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DIFFUSE ALVEOLAR HAEMORRHAGE

  1. 1. DR ASHRAF AHMAD PULMONOLOGIST KAASH - TAIF 2015 DIFFUSE ALVEOLAR HAEMORRHAGE
  2. 2. INTRODUCTION Bleeding into the alveolar spaces characterizes the syndrome of DAH and is due to disruption of the alveolar-capillary basement membrane. This is caused by injury or inflammation of the arterioles, venules, or alveolar septal (alveolar wall or interstitial) capillaries. Hemoptysis is the usual presenting symptom; however it is not always present, even when hemorrhage is severe
  3. 3. CLINICAL PRESENTATION  Symptoms :Cough, hemoptysis, fever, and dyspnea are common initial symptoms. Some patients, however, present with ARDS requiringMV  Physical examination: The pulmonary examination is usually nonspecific, unless there are physical signs of an underlying systemic vasculitis or CT vascular disorder
  4. 4. INVESTIGATIONS  Radiological:  PFTs: increased DLCO  BAL :sequential lavage are progressively more hemorrhagic with hemosiderin-ladenMQ.  Biopsy from the affected tissue
  5. 5. TREATMENT =TTT CAUSE  Glucocorticoids : are the mainstay of therapy for the DAH syndrome associated with systemic vasculitis, connective tissue disease, Goodpasture's syndrome, and isolated pulmonary capillaritis.  Additional immunosuppressive agents (cyclophosphamide or azathioprine)  Plasma exchange : in Goodpasture's syndrom
  6. 6.  Experimental TTT: IVIG, rituximab , aminocaproic acid & Recombinant human coagulation factor VIIa

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