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
Pulmonary complications for drug consumption: Diffuse alveolar hemorrhage.
Medicina intensiva 2021 Nov 01;; — 2021 Nov 01
A new side effect of synthetic cannabinoid use by the bucket (waterpipe) method: Acute respiratory distress syndrome (ARDS).
Turkish journal of emergency medicine 2018 Mar;18;42-44 — 2018 Mar — 42-44
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
Association of pulmonary histopathological findings with toxicological findings in forensic autopsies of illicit drug users.
Vojnosanitetski pregled 2011 Aug;68;639-42 — 2011 Aug — 639-42
[Fatal alveolar haemorrhage following a "bang" of cannabis].
Revue des maladies respiratoires 2011 Sep;28;919-23 — 2011 Sep — 919-23
Pulmonary hemorrhage: a rare complication of opioid overdose.
Pediatric emergency care 2011 Aug;27;742-4 — 2011 Aug — 742-4
Restrepo CS, Artunduaga M, Carrillo JA, Rivera AL, Ojeda P, Martinez-Jimenez S, Manzano AC, Rossi SE
Silicone pulmonary embolism: report of 10 cases and review of the literature.
Journal of computer assisted tomography 2009 Mar-Apr;33;233-7 — 2009 Mar-Apr — 233-7