Abstract | OBJECTIVE: To review clinical, laboratory, and outcome characteristics of children diagnosed with pulmonary capillaritis (PC), a small-vessel vasculitis, presenting as diffuse alveolar hemorrhage (DAH), and to compare these findings with those for children with other alveolar hemorrhage syndromes. STUDY DESIGN: A retrospective chart review of patients who underwent a lung biopsy because of a clinical suggestion of pulmonary hemorrhage. RESULTS: PC was identified in 8 of 23 patients. In these patients, cough, crackles, and hypoxia were common. Alveolar infiltrates on radiography and anemia were present in 7 of 8 cases. Serologic evidence of a systemic vasculitis was present in 50% of patients. High-dose corticosteroids proved effective in controlling alveolar hemorrhage in all cases. There were no presenting signs or symptoms that could differentiate patients with PC from those with non-immune-mediated alveolar hemorrhage. In general, patients with PC had a lower hematocrit and higher erythrocyte sedimentation rate (ESR). CONCLUSION: Children presenting with lower respiratory tract symptoms, chest x-ray abnormalities, and anemia should undergo evaluation for PC, as early initiation of immunosuppression can be lifesaving and organ sparing. No clinical signs to differentiate immune and non-immune-mediated alveolar hemorrhage were evident in this study.
|
Authors | Jason J Fullmer, Claire Langston, Megan K Dishop, Leland L Fan |
Journal | The Journal of pediatrics
(J Pediatr)
Vol. 146
Issue 3
Pg. 376-81
(Mar 2005)
ISSN: 0022-3476 [Print] United States |
PMID | 15756223
(Publication Type: Comparative Study, Journal Article)
|
Topics |
- Biopsy
- Blood Sedimentation
- Capillaries
(pathology)
- Child
- Female
- Hematocrit
- Hemorrhage
(etiology, pathology)
- Humans
- Lung
(blood supply)
- Lung Diseases
(diagnosis, etiology)
- Male
- Pulmonary Alveoli
(pathology)
- Retrospective Studies
- Vasculitis
(diagnosis)
|