title: Diffuse alveolar hemorrhage associated with low molecular weight heparin.
abstract: Diffuse alveolar hemorrhage (DAH) has a varied etiology, including anticoagulation drugs. There is conflicting evidence whether low molecular weight heparin (LMWH) has a low risk of bleeding complications compared to unfractionated heparin. We report here a case of DAH in a 74-year-old woman who was administered enoxaparin, a LMWH, after bilateral total knee arthroplasty. Although congestive heart failure after blood transfusion and fluid infusion could in part be associated with the bleeding, LMWH may be a major cause of DAH since the patient quickly recovered after its cessation. DAH should be of concern when acute respiratory failure with ground-glass shadow develops in both lungs during anticoagulation therapy with LMWH.
authors.affiliation: Division of Respiratory Medicine, Nihon University School of Medicine Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Division of Respiratory Medicine, Nihon University School of Medicine Tokyo, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Maruoka
authors.affiliation: Division of Respiratory Medicine, Nihon University School of Medicine Tokyo, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Division of Respiratory Medicine, Nihon University School of Medicine Tokyo, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Division of Respiratory Medicine, Nihon University School of Medicine Tokyo, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Hashimoto
keywords: diffuse alveolar hemorrhage; enoxaparin; low molecular weight heparin