Clinical Features and Treatment Strategy of Vasculitis-Associated Diffuse Alveolar Hemorrhage
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 11, Issue 1
Abstract
Objectives: To summarize the clinical features and diagnostic approach of patients with vasculitis-associated diffuse alveolar hemorrhage (DAH). To investigate the optimal therapeutic strategy and highlight the effective corticosteroid dose and timing. Methods: A retrospective chart review of the patients who were admitted to the intensive care unit (ICU) due to vasculitis-associated DAH was performed. Patient characteristics, clinical manifestations, the diagnosis of underlying etiology, treatment, and outcome were collected. Results: During January 2015 to December 2017, seven vasculitis-associated DAH patients were reviewed. The mean age ± SD was 53.4 ± 18.2 years. Five patients (71%) were female. DAH was the initial presentation in all seven patients (100%). All patients required immediate mechanical ventilation. As first line therapy, methylprednisolone (MTP) pulse therapy combined with cyclophosphamide pulse therapy were administered to all patients. Six patients survived. Four of them received MTP and cyclophosphamide pulse therapy shortly after admission (mean 1.6 days, range: <1-3days) showed good response to therapy and were extubated successfully within ten days after ICU admission. Conclusion: Vasculitis-associated DAH is a fatal disorder. Once the diagnosis of DAH is confirmed, intensive administration of MTP and cyclophosphamide pulse therapy initiated within 3 days of admission provide good survival and pulmonary outcome.
Authors and Affiliations
Ya-Chih Tien, Ying-Ming Chiu, Ming-Hui Hung, Jin-Lan Shen, Chih-Ming Lin
Keywords
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- EP ID EP587236
- DOI 10.26717/BJSTR.2018.11.002057
- Views 192
- Downloads 0
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