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
Be aware of misdiagnosis tied to COVID-19 focusing: a case report of abciximab-induced alveolar haemorrhage thought to be SARS-CoV-2 in a patient with ST-segment elevation myocardial infarction.
European heart journal. Case reports 2020 Dec;4;1-6 — 2020 Dec — 1-6
Abciximab-induced alveolar hemorrhage treated with rescue extracorporeal membranous oxygenation.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2015 Apr;85;828-31 — 2015 Apr — 828-31
Pulmonary hemorrhage and acute pulmonary thromboembolism after abciximab administration.
The American journal of emergency medicine 2013 Feb;31;450.e1-2 — 2013 Feb — 450.e1-2
A retrospective analysis and case series of glycoprotein IIb/IIIa inhibitor associated diffuse alveolar hemorrhage: two case reports.
Cases journal 2009 Jul 30;2;8553 — 2009 Jul 30 — 8553
A case report of alveolar haemorrhage associated with severe thrombocytopenia induced by abciximab infusion in a patient with an acute coronary syndrome.
Internal and emergency medicine 2008 Dec;3;345-7 — 2008 Dec — 345-7
Abciximab-induced alveolar hemorrhage after percutaneous coronary intervention.
The Canadian journal of cardiology 2008 Feb;24;149-51 — 2008 Feb — 149-51
Usman MH, Shah MA, ul-Islam T, Adenwalla HN, Rahman F, Baqir M, Altaf M, Venkataraman R, Cherayil M, Berger S
Abciximab and fatal pulmonary hemorrhage.
Heart & lung : the journal of critical care 2006 Nov-Dec;35;423-6 — 2006 Nov-Dec — 423-6
Alveolar hemorrhage: an underdiagnosed complication of treatment with glycoprotein IIb/IIIa inhibitors.
Journal of interventional cardiology 2006 Aug;19;356-63 — 2006 Aug — 356-63
Fatal pulmonary haemorrhage with the combined use of abciximab and fibrinolytic agent.
Singapore medical journal 2002 Nov;43;587-9 — 2002 Nov — 587-9
Pulmonary hemorrhage after percutaneous coronary intervention with abciximab therapy.
Mayo Clinic proceedings 2002 Dec;77;1340-3 — 2002 Dec — 1340-3
Alveolar hemorrhage as a complication of treatment with abciximab.
Chest 2001 Jul;120;126-31 — 2001 Jul — 126-31
Diffuse alveolar hemorrhage following administration of tirofiban or abciximab: a nemesis of platelet glycoprotein IIb/IIIa inhibitors.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2000 Feb;49;181-4 — 2000 Feb — 181-4
Fatal alveolar hemorrhage and Abciximab (ReoPro) therapy for acute myocardial infarction.
Catheterization and cardiovascular diagnosis 1998 Jul;44;313-6 — 1998 Jul — 313-6