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
Anai S, Nakayama Y, Gushiken H, Chinen S, Masuda K, Kamiya H, Ueno S, Maeda M, Kiyuna M, Sato Y, Matsumoto T
Diffuse alveolar hemorrhage and acute eosinophilic pneumonia: A rare form of amiodarone pulmonary toxicity diagnosed by bronchoalveolar lavage.
Journal of cardiology cases 2023 Mar;27;93-96 — 2023 Mar — 93-96
Diffuse alveolar hemorrhage: how relevant is etiology?
Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2019;36;47-52 — 2019 — 47-52
Amiodarone and diffuse alveolar hemorrhage.
Advances in respiratory medicine 2020;88;169-171 — 2020 — 169-171
Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication.
BMJ case reports 2019 Oct 25;12; — 2019 Oct 25
Trepopnea due to amiodarone-induced diffuse alveolar hemorrhage.
Respiratory care 2013 Feb;58;e11-3 — 2013 Feb — e11-3
A rare case of acute diffuse alveolar hemorrhage following initiation of amiodarone: a case report.
Military medicine 2012 Jan;177;118-20 — 2012 Jan — 118-20
Amiodarone-induced alveolar haemorrhage: a rare complication of a common medication.
Heart, lung & circulation 2010 Jul;19;435-7 — 2010 Jul — 435-7
Acute alveolar hemorrhage and orthodeoxia induced by intravenous amiodarone.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 1999 May;47;61-3 — 1999 May — 61-3