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Etiology of Hemoptysis in Children and Adolescents - Multicentric Retrospective Data (2012-2021) From Chennai
D Vijayasekaran1, N C Gowrishankar2, B Sarath Balaji3
1Apollo Children's Hospital and Kanchi Kamakoti Child's Trust Hospital, Chennai, Tamil Nadu.
Insights
Idiopathic pulmonary hemorrhage is the most common cause of hemoptysis in children. Severity of bleeding, from mild to severe, can help pinpoint the underlying cause, guiding necessary investigations.
Area of Science:
- Pediatric Pulmonology
- Pediatric Critical Care
Background:
- Hemoptysis in children presents a diagnostic challenge due to its broad etiology.
- Understanding the correlation between bleeding severity and cause is crucial for effective management.
Purpose of the Study:
- To analyze the causes of hemoptysis in pediatric patients.
- To correlate the severity of hemoptysis with its underlying etiology.
Main Methods:
- Retrospective multicenter study of inpatient records from four tertiary pediatric hospitals in Tamil Nadu (April 2012-March 2021).
- Included children aged 2 months to 15 years with hemoptysis, excluding those with known bleeding disorders.
- Categorized hemoptysis into mild, moderate, and severe based on bleeding intensity.
Main Results:
- Out of 73 children, 82.2% had mild, 12.3% had moderate, and the rest had severe hemoptysis.
- Idiopathic pulmonary hemorrhage was the most frequent cause overall.
- Mild hemoptysis was commonly linked to idiopathic pulmonary hemorrhage, tuberculosis, and pneumonia.
- Congenital airway and vascular anomalies were more often associated with moderate to severe bleeding.
Conclusions:
- The etiology of pediatric hemoptysis is diverse.
- Classifying hemoptysis by severity (mild, moderate, severe) can provide valuable clues to the underlying cause.
- Severity-based categorization aids in narrowing down diagnostic investigations, optimizing resource utilization.
Objective:
To analyze the etiology of hemoptysis in children and to correlate the severity of bleed with the etiology.
Methods:
This retrospective multicentre study reviewed data from inpatient units of four tertiary care public and private sector pediatric hospitals in Tamil Nadu. Methods: Inpatient case records of children (aged 2 month-15 years) treated for hemoptysis at the four institutions between April, 2012 and March, 2021 were identified, after ethical clearance from respective institutions. Data of children with underlying known bleeding disorders like hemophilia or platelet abnormality were excluded from the study. Hemoptysis was categorized as mild, moderate and severe.
Results:
Of the 73 children who had presented with hemoptysis during the study period, 60 (82.2%) children had mild, 9 (12.3%) had moderate and rest had severe hemoptysis. Idiopathic pulmonary hemorrhage was the most common cause of hemoptysis. The common causes of mild hemoptysis in children were idiopathic pulmonary hemorrhage (n=15, 25%), pulmonary tuberculosis (n=12, 20%) and pneumonia (n=8, 13.3%). Congenital airway anomalies and vascular anomalies were more likely to present with moderate to severe bleed.
Conclusions:
Etiology of hemoptysis is broad and categorizing them into mild, moderate and severe may give a clue about the possible etiology, there by restricting to the required investigations.
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