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The etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience
BACKGROUND: Diffuse alveolar hemorrhage (DAH) is a life-threatening syndrome that may be caused by numerous disorders. There is scant data on the etiology and characteristics of DAH in children. METHODS: We retrospectively reviewed the clinical records of patients admitted to a tertiary pediatric ho...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649607/ https://www.ncbi.nlm.nih.gov/pubmed/34976758 http://dx.doi.org/10.21037/tp-21-283 |
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author | Qi, Yuanyuan Wang, Libo Qian, Liling Zhang, Xiaobo |
author_facet | Qi, Yuanyuan Wang, Libo Qian, Liling Zhang, Xiaobo |
author_sort | Qi, Yuanyuan |
collection | PubMed |
description | BACKGROUND: Diffuse alveolar hemorrhage (DAH) is a life-threatening syndrome that may be caused by numerous disorders. There is scant data on the etiology and characteristics of DAH in children. METHODS: We retrospectively reviewed the clinical records of patients admitted to a tertiary pediatric hospital with DAH over a 10-year period. The syndrome was classified into five groups according to different etiologies, and the characteristics and outcomes of patients were compared. RESULTS: A total of 74 children were included in the study. Idiopathic pulmonary hemosiderosis (IPH) was the most frequent cause (64.9%), followed by miscellaneous causes (infection and other conditions) (16.2%), immune-mediated disorders (9.5%), liver dysfunction (5.4%), and cardiovascular disorders (4.1%). The median age of the patients was 3.5 years (ranging from 1.5 to 7 years), and no difference was found in the proportion of fever, crackles, and pulmonary infiltrates among the five etiological groups. There was no difference in the proportion of blood transfusions among the groups. Cardiac catheterization was performed on 31 patients for whom the diagnostic workup was negative and were suspected of having IPH, and abnormal signs were observed and bronchial artery embolization (BAE) was performed in all those patients. The patients with IPH had the lowest mortality, while those with DAH secondary to liver failure had the highest mortality. Patients in BAE group had a shorter duration of corticosteroids and a lower relapse rate than non-BAE group. CONCLUSIONS: Idiopathic pulmonary hemosiderosis is a common etiology of DAH and has a good prognosis in children. Vascular abnormalities were observed in the patients with IPH. Further studies are needed to clarify the role of vascular malformations in IPH. |
format | Online Article Text |
id | pubmed-8649607 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-86496072021-12-30 The etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience Qi, Yuanyuan Wang, Libo Qian, Liling Zhang, Xiaobo Transl Pediatr Original Article BACKGROUND: Diffuse alveolar hemorrhage (DAH) is a life-threatening syndrome that may be caused by numerous disorders. There is scant data on the etiology and characteristics of DAH in children. METHODS: We retrospectively reviewed the clinical records of patients admitted to a tertiary pediatric hospital with DAH over a 10-year period. The syndrome was classified into five groups according to different etiologies, and the characteristics and outcomes of patients were compared. RESULTS: A total of 74 children were included in the study. Idiopathic pulmonary hemosiderosis (IPH) was the most frequent cause (64.9%), followed by miscellaneous causes (infection and other conditions) (16.2%), immune-mediated disorders (9.5%), liver dysfunction (5.4%), and cardiovascular disorders (4.1%). The median age of the patients was 3.5 years (ranging from 1.5 to 7 years), and no difference was found in the proportion of fever, crackles, and pulmonary infiltrates among the five etiological groups. There was no difference in the proportion of blood transfusions among the groups. Cardiac catheterization was performed on 31 patients for whom the diagnostic workup was negative and were suspected of having IPH, and abnormal signs were observed and bronchial artery embolization (BAE) was performed in all those patients. The patients with IPH had the lowest mortality, while those with DAH secondary to liver failure had the highest mortality. Patients in BAE group had a shorter duration of corticosteroids and a lower relapse rate than non-BAE group. CONCLUSIONS: Idiopathic pulmonary hemosiderosis is a common etiology of DAH and has a good prognosis in children. Vascular abnormalities were observed in the patients with IPH. Further studies are needed to clarify the role of vascular malformations in IPH. AME Publishing Company 2021-11 /pmc/articles/PMC8649607/ /pubmed/34976758 http://dx.doi.org/10.21037/tp-21-283 Text en 2021 Translational Pediatrics. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Qi, Yuanyuan Wang, Libo Qian, Liling Zhang, Xiaobo The etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience |
title | The etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience |
title_full | The etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience |
title_fullStr | The etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience |
title_full_unstemmed | The etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience |
title_short | The etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience |
title_sort | etiology, clinical profile, and outcome of diffuse alveolar hemorrhage in children: a ten-year single-center experience |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649607/ https://www.ncbi.nlm.nih.gov/pubmed/34976758 http://dx.doi.org/10.21037/tp-21-283 |
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