Hemoptysis in Israeli CF patients--prevalence, treatment, and clinical characteristics.
OBJECTIVE
To identify the characteristics of CF patients with hemoptysis in Israel and to compare clinical features and risk factors to a control group of CF patients without hemoptysis.


METHODS
Retrospective chart review.


METHODS
All CF patients in Israel who experienced hemoptysis between 2001 and 2005 and a control group of sex- and age-matched patients with no history of hemoptysis.


RESULTS
40/440 CF patients (9.1%) experienced hemoptysis during the study period, 50% were male. Ten patients (25%) were under 13 years old at the first hemoptysis episode. Pulmonary exacerbation was the precipitating factor in 90%. Twenty three patients showed moderate or major hemoptysis. 35/40 patients responded well to conservative therapy. Bronchial artery embolization (BAE) was performed in 5 patients with no recurrence of bleed within 24 h. However all of these patients experienced recurrent hemoptysis. One patient died during the follow-up period because of end stage lung disease. Pulmonary function tests, body-mass index, coagulation tests, pancreatic status, presence of bronchiectasis, sputum cultures and genetic mutations were similar in the two groups. A high incidence (57.5%) of associated diseases including cystic fibrosis related diabetes, cirrhosis and portal hypertension, and distal intestinal obstruction syndrome was found among hemoptysis patients, compared to only 5.2% in the control group (p<0.001).


CONCLUSIONS
Hemoptysis, even major, did not seem to be a risk factor for mortality in our patients. A higher incidence of hemoptysis was found in our pediatric patients compared to other series. BAE shows a high immediate rate of success in controlling hemoptysis, but does not prevent future disease.
Efrati
Ori
O
Pediatric Pulmonology Unit, Safra Children's hospital, Tel Hashomer. Israel. Electronic address: ori.efrati@sheba.health.gov.il.
Harash
Oshrit
O
Pediatric Pulmonology Unit, Safra Children's hospital, Tel Hashomer. Israel.
Rivlin
Joseph
J
Cystic Fibrosis Center, Carmel Medical Center, Haifa, Israel.
Bibi
Haim
H
Cystic Fibrosis Center, Carmel Medical Center, Haifa, Israel.
Meir
Mei-Zahav
MZ
Graub Cystic Fibrosis Center, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Blau
Hannah
H
Graub Cystic Fibrosis Center, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Mussaffi
Huda
H
Graub Cystic Fibrosis Center, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Barak
Asher
A
Pediatric Pulmonology Unit, Safra Children's hospital, Tel Hashomer. Israel.
Levy
Isaac
I
Pediatric Pulmonology Unit, Safra Children's hospital, Tel Hashomer. Israel.
Vilozni
Daphna
D
Pediatric Pulmonology Unit, Safra Children's hospital, Tel Hashomer. Israel.
Kerem
Eitan
E
Department of Pediatrics, Hadassah University Hospital, Mount Scopus, Hebrew University Medical School, Jerusalem, Israel.
Modan-Moses
Dalit
D
Pediatric Pulmonology Unit, Safra Children's hospital, Tel Hashomer. Israel.
D000293:Adolescent; D000328:Adult; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006469:Hemoptysis / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D007557:Israel / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D055815:Young Adult