Clinical profile of 30 infants with acute pulmonary hemorrhage in Cleveland.
Between 1993 and 2000, 30 infants were hospitalized with acute pulmonary hemorrhage at Rainbow Babies and Children's Hospital in Cleveland. Most infants presented with severe pulmonary symptoms requiring intensive support, but a few infants had less severe hemorrhage. Three quarters of the patients required ventilator support and blood transfusions. Eleven patients had transitory hemoglobinuria. Five patients died, but infants who survived did well. There are currently no specific treatment modalities, although we have advised moving to a different home and avoiding environmental tobacco smoke. Subsequently, rebleeding from the lower respiratory tract has decreased from 5 of 7 infants to 1 in 21. On the basis of decreased subsequent fatal hemorrhage, high dose glucocorticoids seem to be of some value. Several patients revealed continued low-grade alveolar hemorrhage for months after their initial bleed, even after removal from their original home environments.
Pediatric Pulmonary Division, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio 44106-5000, USA. dxd9@po.cwru.edu
Dorr G
DG
Dearborn
Paul G
PG
Smith
Beverly B
BB
Dahms
Terrence M
TM
Allan
W G
WG
Sorenson
Eduardo
E
Montana
Ruth A
RA
Etzel
D000208:Acute Disease; D016000:Cluster Analysis; D004200:Diseases in Twins; D004781:Environmental Exposure / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006486:Hemosiderosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D009820:Ohio / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D013191:Stachybotrys; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
D014028:Tobacco Smoke Pollution