title: Exercise-induced pulmonary hemorrhage in a nonathlete: case report and review of physiology.
abstract: The integrity of the pulmonary blood-gas barrier is vulnerable to intense exercise in elite athletes, similar to the phenomenon of exercise-induced pulmonary hemorrhage in thoroughbred racehorses. A 50-year-old previously healthy man presented with acute onset shortness of breath, dry cough, and hypoxemia after engaging in an extremely vigorous game of handball. CT scan of the chest showed diffuse patchy air-space disease. Bronchoalveolar lavage revealed diffuse alveolar hemorrhage. Infectious etiologies and bleeding diatheses were excluded by laboratory testing. Serological tests for ANCA-associated vasculitis, lupus, and Goodpasture's disease also were negative. A transthoracic echocardiogram was normal. The patient recovered completely on supportive therapy in less than 72 h. This case demonstrates strenuous exercise as a cause of diffuse alveolar hemorrhage in a previously healthy male with no apparent underlying cardiopulmonary disease.
authors: Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA.
authors: Amit
authors: A
authors: Diwakar
authors: Gregory A
authors: GA
authors: Schmidt
mesh_terms: D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D018893:Bronchoalveolar Lavage; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D055370:Lung Injury / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome