Cryptogenic hemoptysis in chronic obstructive pulmonary disease: characteristics and outcome.
BACKGROUND
Hemoptysis is a common presenting symptom and cause of hospitalization in the department of respiratory diseases. In a number of patients with chronic obstructive pulmonary disease (COPD) presenting with this symptom, investigations fail to reveal a precise etiology. Little data are available regarding characteristics and outcome of COPD patients presenting with cryptogenic hemoptysis (CH).


OBJECTIVE
Our study goal was to assess the functional characteristics of these subjects, the risk factors for CH and the severity of hemoptysis, as well as long-term outcome.


METHODS
For more than 1 year, we enrolled and followed a group of 39 consecutive COPD patients admitted to our center with CH.


RESULTS
Between 1988 and 2003, 39 patients with COPD were admitted for CH in which investigation failed to reveal an etiology. The mean age was 51.3 years. All subjects were active smokers. Twenty-one patients (54%) had at least 1 risk factor for prolonged bleeding. Patients with more severe airflow obstruction tended to have more severe bleeding. Bronchoscopy appeared as useful as a computed tomography in locating the bleeding site. Arterial embolization succeeded in controlling bleeding in all patients who underwent angiography. One patient experienced a relapse in bleeding at 2 months. One developed lung cancer after 1 year. Thirty-four patients were followed for an average of 5 years. Only 2 subjects experienced recurrent hemoptysis. None died.


CONCLUSIONS
CH in patients with COPD is associated with a favorable short- and long-term outcome when managed with timely angiographic embolization. Long-term incidence of lung cancer was uncommon after an episode of CH, and recurrences of hemoptysis were rare.
Delage
Antoine
A
Department of Respiratory Diseases, Pasteur Hospital, University of Nice-Sophia Antipolis, Nice, France.
Tillie-Leblond
Isabelle
I
Cavestri
Béatrice
B
Wallaert
Benoit
B
Marquette
Charles-Hugo
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D001999:Bronchoscopy; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000150:complications* / Q000628:therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012008:Recurrence; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed