Abstract
Introduction: Antithrombotic therapy has been increasingly recognized as a cause of diffuse alveolar hemorrhage(DAH). However, there have been few reports on clinical features and outcomes of patients with DAH during antithrombotic therapy.
Aims: To clarify features and mortality of DAH during antithrombotic therapy.
Methods: We retrospectively reviewed 54 patients who were diagnosed with DAH from January 2009 to July 2013. DAH was confirmed when bronchoalveolar lavage aliquots were progressively more hemorrhagic.
Results: Twenty-eight patients were associated with antithrombotic thrapy, but 7 of them had another cause of DAH (1 patient had drug-induced pneumonia, 2 patients had acute exacerbation of interstitial pneumonia, 3 patients had anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis, and 1 patient had thrombocytopenia due to myelodysplastic syndromes). Among the remaining 21 patients, 15 (71%) had heart failure and 11 (52%) had renal failure. Five (24%) of the 21 patients died, and 3 (14%) of them needed dialysis. The number of patients who needed dialysis during treatment of DAH was statistically higher among non-survivors than among survivors (60% vs. 13%, P=0.03)
Conclusions: DAH due to antithrombotic therapy occurred frequently among patients with heart failure or renal failure. Patients who needed dialysis during treatment of DAH had poorer outcomes.
- © 2014 ERS
