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Clinical features and outcomes of patients with diffuse alveolar hemorrhage during antithrombotic therapy

Takehiro Otoshi, Ryoji Kato, Ryoko Shimizu, Daichi Hujimoto, Takahisa Kawamura, Koji Tamai, Takeshi Matsumoto, Kazuma Nagata, Kyoko Otsuka, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
European Respiratory Journal 2014 44: P3776; DOI:
Takehiro Otoshi
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Ryoji Kato
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Ryoko Shimizu
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Daichi Hujimoto
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Takahisa Kawamura
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Koji Tamai
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Takeshi Matsumoto
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Kazuma Nagata
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Kyoko Otsuka
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Atsushi Nakagawa
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Kojiro Otsuka
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Keisuke Tomii
1Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, Japan
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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.

  • Acute respiratory failure
  • Bronchoalveolar lavage
  • Treatments
  • © 2014 ERS
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Clinical features and outcomes of patients with diffuse alveolar hemorrhage during antithrombotic therapy
Takehiro Otoshi, Ryoji Kato, Ryoko Shimizu, Daichi Hujimoto, Takahisa Kawamura, Koji Tamai, Takeshi Matsumoto, Kazuma Nagata, Kyoko Otsuka, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
European Respiratory Journal Sep 2014, 44 (Suppl 58) P3776;

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Clinical features and outcomes of patients with diffuse alveolar hemorrhage during antithrombotic therapy
Takehiro Otoshi, Ryoji Kato, Ryoko Shimizu, Daichi Hujimoto, Takahisa Kawamura, Koji Tamai, Takeshi Matsumoto, Kazuma Nagata, Kyoko Otsuka, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
European Respiratory Journal Sep 2014, 44 (Suppl 58) P3776;
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