The Drug-Induced Respiratory Disease Website
(Fr: hémorragie alvéolaire pure, isolée, sans auto-Ac). Diffuse bland alveolar hemorrhage (DAH). Can be severe or fatal (PMID 26236607). When unassociated with pulmonary vasculitis or capillaritis, the condition is named bland diffuse alveolar hemorrhage (DAH). Caution: hemosiderin-laden BAL macrophages can be found in DAD (PMID 19129275). Laboratory clues to this condition include ANA, ANCA, platelets and coagulation studies (INR, and full blood count). DAH may unravel thrombocytopenia (that may be drug-induced), coaculopathy, ANA- or ANCA- and, less often, anti-GBM-(drug)-related disease. Pulmonary capillaritis is more often suspected than proved, as the lung biopsy is generally avoided if typical gross BAL features for AH are present. ANCA of MPO-, HNE- or, less often, -PR3 with multispecificity and high titers suggest the drug etiology. Drug-induced DAH can mimic primary ANCA-related micropolyangiitis or 'Wegener's'. See PMID 19592204, 20442117, 21606695, 21674416. A search for underlying pulmonary condition at the origin of hemorrhage (e.g. lung cancer, bronchiectasis) is indicated. See also under IIIb, VId, Xs, Xz, XVIIv. 2018 review @PMID 30404115
Publications
Alveolar hemorrhage due to marijuana smoking using water pipe made with plastic bottle: case report and narrative review of the literature.
Inhalation toxicology 2021 Jun 28;;1-9 — 2021 Jun 28 — 1-9
Cannabis-Related Diffuse Alveolar Hemorrhage in a 16-Year-Old Patient: A Case Report.
Frontiers in pediatrics 2019;7;468 — 2019 — 468
[Alveolar haemorrhage following a cannabis water pipe].
Revue de pneumologie clinique 2016 Oct;72;316-319 — 2016 Oct — 316-319
A Case Report of Cannabis Induced Hemoptysis.
Medicine 2016 Mar;95;e3232 — 2016 Mar — e3232
de Prost N, Parrot A, Cuquemelle E, Picard C, Antoine M, Fleury-Feith J, Mayaud C, Boffa JJ, Fartoukh M, Cadranel J
Diffuse alveolar hemorrhage in immunocompetent patients: etiologies and prognosis revisited.
Respiratory medicine 2012 Jul;106;1021-32 — 2012 Jul — 1021-32
[Fatal alveolar haemorrhage following a "bang" of cannabis].
Revue des maladies respiratoires 2011 Sep;28;919-23 — 2011 Sep — 919-23
Brodifacoum intoxication with marijuana smoking.
Archives of pathology & laboratory medicine 1997 Jan;121;67-9 — 1997 Jan — 67-9