Diffuse Alveolar Hemorrhaging with Hypertensive Emergency: A Rare but Important Cause of Hemoptysis

Abstract

Hypertensive emergency, which occurs even in young adults, induces systemic organ damage and results in a poor prognosis. We herein report the case of a 27-year-old man who developed alveolar hemorrhaging with hypertensive emergency. He presented with bloody sputum, renal failure, and extremely high blood pressure (200/128 mmHg). Chest computed tomography revealed diffuse bilateral alveolar infiltrates suggestive of diffuse alveolar hemorrhaging. After intensive therapy with anti-hypertensive drugs, the alveolar hemorrhaging disappeared. Renal impairment was partially reversed. Therefore, we conclude that hypertensive emergency should be considered as a possible cause of hemoptysis, even in young adults.

Pheochromocytoma-induced diffuse alveolar hemorrhage after cholecystectomy: A case report and literature review

“…It is challenging to figure out a clear pathophysiological relationship between PPGLs and alveolar hemoptysis because the process that causes alveolar hemoptysis in people has not been fully identified [ 16 ]. Previous evidence [ 29 ] suggests that severe hypertension can precipitate the onset of alveolar bleeding. When catecholamines rise, they mostly act on α-adrenergic receptors.…”

Diffuse Alveolar Hemorrhage Associated with Dilated Cardiomyopathy and Sleep Apnea Syndrome

“…Chronic heart failure increases pulmonary venous pressure, which might induce micro-vessel rupture, resulting in DAH ( 13 , 14 ). Interestingly, a recent study showed that cardiovascular diseases increased long-term mortality in patients with DAH ( 15 ), which is indicative of a close pathophysiologic relationship between them.…”

Diffuse Alveolar Hemorrhage: A Rare Complication of Severe Hypertension

“…Renin, aldosterone, vasopressin, catecholamines and endothelin might be involved in the alveolar-capillary injury. Finally, the bronchopulmonary arteries might have suffered directly from severe systemic hypertension in some patients as the bronchopulmonary arteries derive their blood supply from the systemic and pulmonary circulations or alveolar septal vessels [6].…”