PT  - JOURNAL ARTICLE
AU  - Koji Tamai
AU  - Takehiro Otoshi
AU  - Daichi Fujimoto
AU  - Takahisa Kawamura
AU  - Takeshi Matsumoto
AU  - Kazuma Nagata
AU  - Kyoko Otsuka
AU  - Atsushi Nakagawa
AU  - Kojiro Otsuka
AU  - Keisuke Tomii
TI  - Diffuse alveolar hemorrhage dominant in right lung is due to cardiac comorbidity
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P2347
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P2347.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P2347.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Background: Diffuse alveolar hemorrhage (DAH) with lateral dominance, especially on the right side, is often observed in clinical practice.Aims: To describe clinical aspects of right side dominant DAH.Methods: We retrospectively reviewed data from 394 bronchoalveolar lavage fluid (BALF) specimens between January 2009 and December 2012 and patients who presented with progressively bloodier BALF were evaluated. Unilateral dominance on chest X-ray (CXR) was determined as follows: Infiltration area of the dominant side was more than twice the infiltration area of the other side.Results: A total of 43 patients were evaluated. The etiology of DAH was as follows; heart failure (n=12), clotting disorder (n=10), pneumonia (n=4), acute myeloid leukemia (n=3), vasculitis (n=2), systemic lupus erythematosus (n=2), acute exacerbation of interstitial pneumonia (n=2), drug-induced lung injury (n=1), undefined (n=7). Fifteen patients (34.9%) were right lung dominant, 3 patients (7.0%) were left lung dominant and 25 patients (58.1%) showed bilateral infiltration on CXR. Multivariate logistic regression analysis revealed that co-morbidities of cardiovascular diseases (CVD) (OR 31.9, 95% CI 1.6-2598.1), and atrial fibrillation (Af) (OR 38.4, 95% CI 2.9-2036.2) were significant factors in right lung dominant DAH. In addition, need for mechanical ventilation was a simple factor used to denote in-hospital mortality using multivariate logistic regression analysis.Conclusions: DAH dominance in right lung was significantly related to co-morbidities of CVD and Af, but not related to in-hospital mortality.