title: Diffuse Alveolar Hemorrhage in Autoimmune Diseases.
abstract: OBJECTIVE
  The present paper establishes a narrative and analytical review of diffuse alveolar hemorrhage (DAH) in ANCA-associated vasculitis, systemic lupus erythematosus, and antiphospholipid syndrome.
  
  
  RESULTS
  Recent studies found a frequent association between DAH and infections and systemic lupus erythematosus and its associated factors. Biological therapies like rituximab have demonstrated benefit mainly in patients with ANCA-associated vasculitis. Main clinical manifestations of diffuse alveolar hemorrhage in these three diseases include dyspnea, pulmonary infiltrates, cough, and hypoxemia. The presence of hemorrhagic bronchoalveolar lavage, hemosiderin containing macrophages, or an increase of carbon monoxide diffusing capacity have been described in some series as helpful findings for the diagnosis. Hemoptysis has been seen mainly in systemic lupus erythematosus. The cornerstone of therapy includes glucocorticoids and cyclophosphamide, and recent findings in ANCA-associated vasculitis suggest the similar benefit of rituximab. Future evaluations and systematic reviews will help to define the real benefit for therapies that appeared to be controversial at the moment.
authors.affiliation: Faculty of Medicine, Universidad Autónoma San Luis Potosí and Hospital Central "Dr. Ignacio Morones Prieto", Avenida Venustiano Carranza 2395, Zona Universitaria, 78290, San Luis Potosí, San Luis Potosí, Mexico.|Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, San Luis Potosí, San Luis Potosí, Mexico.
authors.forename: Marco Ulises
authors.initials: MU
authors.lastname: Martínez-Martínez
authors.affiliation: Faculty of Medicine, Universidad Autónoma San Luis Potosí and Hospital Central "Dr. Ignacio Morones Prieto", Avenida Venustiano Carranza 2395, Zona Universitaria, 78290, San Luis Potosí, San Luis Potosí, Mexico.|Hospital General de Zona No. 50, Instituto Mexicano del Seguro Social, San Luis Potosí, San Luis Potosí, Mexico.
authors.forename: David Alejandro Herrera-van
authors.initials: DAH
authors.lastname: Oostdam
authors.affiliation: Faculty of Medicine, Universidad Autónoma San Luis Potosí and Hospital Central "Dr. Ignacio Morones Prieto", Avenida Venustiano Carranza 2395, Zona Universitaria, 78290, San Luis Potosí, San Luis Potosí, Mexico. c_abud@hotmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Abud-Mendoza
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications / Q000401:mortality; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000401:mortality; D001327:Autoimmune Diseases / Q000150:complications* / Q000401:mortality; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000401:mortality; D011379:Prognosis; D011650:Pulmonary Alveoli; D012307:Risk Factors
keywords: Antiphospholipid syndrome; Diagnosis; Diffuse alveolar hemorrhage; Systemic lupus erythematosus; Treatment; Vasculitis