title: [Alveolar hemorrhage].
abstract: Diffuse alveolar hemorrhage (DAH) is defined by the presence of red blood cells originating from the lung capillaries or venules within the alveoli. The diagnosis is established on clinical features, radiological pattern, and especially bronchoalveolar lavage. Diffuse alveolar hemorrhage may have many immune or non-immune causes. Immune causes of DAH include vasculitides, connective tissue diseases, especially systemic lupus erythematosus, and antiglomerular basement membrane antibody disease (Goodpasture's syndrome). Treatment is both supportive and causal, often based on high dose corticosteroids and immunosuppressive therapy (especially intravenous cyclophosphamide). Plasma exchanges are performed in antiglomerular basement membrane antibody disease and systemic lupus erythematosus, and are considered in systemic vasculitis. Non-immune causes of DAH mainly include heart diseases, coagulation disorders, infections, drug toxicities and idiopathic DAH. Treatment of non-immune DAH is that of its cause. Whatever the cause, DAH is an emergency requiring prompt assessment and early treatment.
authors.affiliation: INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, université de Lyon, université Claude-Bernard Lyon 1, Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Traclet
authors.forename: R
authors.initials: R
authors.lastname: Lazor
authors.forename: J-F
authors.initials: JF
authors.lastname: Cordier
authors.forename: V
authors.initials: V
authors.lastname: Cottin
mesh_terms: D000465:Algorithms; D019867:Anti-Glomerular Basement Membrane Disease / Q000150:complications; D001706:Biopsy; D018893:Bronchoalveolar Lavage; D002446:Celiac Disease / Q000150:complications; D015267:Churg-Strauss Syndrome / Q000150:complications; D003240:Connective Tissue Diseases / Q000150:complications; D005938:Glucocorticoids / Q000627:therapeutic use; D006084:Graft Rejection; D014890:Granulomatosis with Polyangiitis / Q000150:complications; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications; D007922:Leptospirosis / Q000150:complications; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016040:Lung Transplantation / Q000009:adverse effects; D011650:Pulmonary Alveoli; D014657:Vasculitis / Q000150:complications
chemical_list: D005938:Glucocorticoids