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Updated: Dec 20, 2025

A Model of Acute Lung Injury Following Visceral Ischemia-Reperfusion by Supra-Coeliac Aortic Cross Clamping in Rats
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Diffuse alveolar hemorrhage: how relevant is etiology?

André Terras Alexandre1, Artur Vale1, Teresa Gomes1

  • 1Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro.

Sarcoidosis, Vasculitis, and Diffuse Lung Diseases : Official Journal of WASOG
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Diffuse Alveolar Hemorrhage (DAH) is a severe condition. Immune-related DAH presents in younger patients and leads to worse outcomes compared to non-immune causes.

Keywords:
alveolardiffusehemorrhage

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Area of Science:

  • Pulmonology
  • Rheumatology
  • Critical Care Medicine

Background:

  • Diffuse Alveolar Hemorrhage (DAH) is a rare, life-threatening syndrome requiring prompt diagnosis.
  • Understanding DAH etiology is crucial for effective management and improved patient outcomes.

Purpose of the Study:

  • To characterize patients with DAH.
  • To compare the presentation and evolution of DAH based on its underlying cause (immune vs. non-immune).

Main Methods:

  • Retrospective review of clinical records for patients diagnosed with DAH over a 7-year period.
  • DAH diagnosis confirmed by clinical criteria (hemoptysis, pulmonary infiltrates, anemia) and hemorrhagic bronchoalveolar lavage (BAL) or siderophagic alveolitis.
  • Patients categorized into immune (e.g., vasculitis, lupus) and non-immune (e.g., heart disease, drug toxicity) groups for comparative analysis.

Main Results:

  • 24 DAH patients identified: 11 immune (7 p-ANCA vasculitis, 2 SLE) and 13 non-immune (6 heart disease).
  • Immune DAH patients were younger (56.6 vs. 67.9 years) and presented with more severe disease, including higher rates of pulmonary-renal syndrome, kidney failure, shock, and ICU admission.
  • In-hospital mortality was exclusively observed in the immune DAH group (12.5%).

Conclusions:

  • Immune-mediated DAH is associated with younger patient demographics.
  • Patients with immune DAH experience more severe clinical presentations and poorer outcomes, including higher mortality.
  • Etiological classification is vital for predicting DAH severity and guiding treatment strategies.