Abstract
Background: The hemoptysis and lung hemorrhage is very rare symptoms for pulmonary sarcoidosis (PS) modifying the typical clinical and radiological disease picture.
Aim: To analyze causes of hemoptysis and lung hemorrhage in PS patients (pts) with the use of modern abilities of radiological assessment (computed tomography - CT, high resolution CT - HRCT, CT with angiography, single photon emission CT - SPECT) and bronchoscopy.
Methods: We studied 30 patients (f/m – 17/13) with morphologically confirmed PS with hemoptysis and lung hemorrhage (stages: 1st – 4, 2nd – 9, 3rd – 12, 4th – 5). The average age was 37,2±2,3 years. All patients were subjected to clinical and radiological (HRCT, CT with angiography, SPECT) researches and bronchoscopy.
Results: The main causes of this severe complication were pulmonary embolism (17 pts including thrombosis “in situ” in 3 of them) with pulmonary arterial hypertension, atrophic bronchitis (3 pts), traction bronchoectasis (3 pts), dry cavities (2 pts), tuberculosis (1 pt). In carrying out bronchoscopy hemoptysis was found in lung tissue viral and bacterial infections (2 pts) and lung cancer (1 pt). The relapsing lung hemorrhage was observed in only one patient with 4 stage PS complicated by micetome in fibrotic tissue. In 3 pts bronchoscopy was performed on top of bleeding using various methods of endobronchial hemostasis.
Conclusion: Using modern methods of radiological imaging (CT, HRCT, CT with angiography, SPECT) allows to detect the main cause of hemoptysis in PS patients – pulmonary embolism including thrombosis “in situ”.
- © 2011 ERS