[Non rheumatic pulmonary hemorrhage: case series description].
BACKGROUND
Pulmonary hemorrhage (PH) is characterized by diffuse hemorrhage from the pulmonary microvasculature. Its main features are dyspnea, hemoptysis, diffuse bilateral alveolar infiltrate and sudden fall in hemoglobin. Because the conditioning causes can be both: rheumatic and non-rheumatic, early recognition of the precipitating causes aids in orienting specific therapy.


OBJECTIVE
To identify the clinical and paraclinical features of non-rheumatic PH and determine the associated mortality.


METHODS
The charts of all patients diagnosed with HP in this institution between 1987 and 1997 were reviewed. OPERATIVE DESCRIPTIONS (DEFINITION): HP was confirmed by bronchoscopy, pulmonary biopsy, necropsy or at least three of the following criteria: a.--Sudden dyspnea, b.--Hemoptysis, c.--Hb decrease of 1 g/dL or more, d.--Recent alveolar infiltrate in the chest X-ray.


METHODS
Descriptive statistics.


RESULTS
Nine cases of non rheumatic PH were identified. Median age of patients was 34 years. Six cases corresponded to men, chemotherapy was associated in three patients. The duration from diagnosis of the underlying disease to HP was one to 73 months. All the patients presented dyspnea, crepitant ates tachycardia, decrease in Hb (median 2 g/dL), hypoxemia a mean of 53.4 mmHg. A diffuse interstitial pattern was evident in X rays of six cases; bronchoscopy was performed in three. Seven patients died, six because of massive pulmonary hemorrhage as the direct cause of death and one because of ARDS.


CONCLUSIONS
PH occurs in hematological diseases accompanied by severe thrombocytopenia and progressive pulmonary infections. Because its associated with high mortality, early detection and treatment are of utmost importance.
Tore Delgadilo
A
A
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
Morales Buenrrostro
L E
LE
Hernández Cruz
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged
Hemorragia pulmonar de causa no reumática: descripción de una serie de casos.