Diffuse Alveolar Hemorrhage Due to Malignant Arterial Hypertension – an Unusual Manifestation of a Common Disease

Abstract

Diffuse alveolar hemorrhage is a clinicopathological syndrome that often leads to respiratory failure, with associated hemoptysis and anemia. Chest radiograph presents non-specific findings of perihilar infiltrates, while computed tomography shows ground-glass attenuation or areas of consolidation with interlobular septal thickening. Bronchoalveolar lavage is used to confirm the clinical and radiological suspicion.While vasculitis and other causes of pulmonary renal syndrome are the most common causes of diffuse alveolar hemorrhage, malignant hypertension should be considered in the proper clinical setting. We present a case report of a 51-year-old previously healthy patient that was diagnosed with diffuse alveolar hemorrhage and acute renal failure due to malignant hypertension, through clinical and radiological findings.

Hypertensive emergency presenting with diffuse alveolar hemorrhaging and thrombotic microangiopathy: A case report and review of the literature

“…We searched previous case reports on HE with DAH and compared clinical findings, renal pathological features, and prognoses. To the best of our knowledge, there have been only 6 reports of HE manifesting with DAH [ 1 , 6 , 7 , 8 , 9 , 10 ]. An overview of previous reports is shown in Table 2 .…”

“…Lung opacities started to clear within two days of presentation. [ 10 ] 27 Male Hemoptysis 180/100 3.11 Smooth muscle cell hyperplasia in the media of interlobular artery, Fibrinoid necrosis and intramural thrombi of small arterioles, collapsed glomerulus by ischemia Steroid pulse therapy (discontinued in a few days), blood pressure control Not require dialysis, Serum creatinine level was 1.98 mg/dL at 10 months after discharge. [ 9 ] 41 Male Cough, hemoptysis, dyspnea 233/159 11.69 Collapsed glomerulus by ischemia A small artery showed onion skin thickening with a narrowed lumen.…”