Review Article
Diffuse Alveolar Hemorrhage
José Javier Gómez-Román
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apagrj@humv.es
Correspondence: Dr J.J. Gómez-Román Departamento de Anatomía Patológica Hospital Universitario Marqués de Valdecilla Avda Valdecilla, s/n 39008 Santander, Cantabria, Spain
Correspondence: Dr J.J. Gómez-Román Departamento de Anatomía Patológica Hospital Universitario Marqués de Valdecilla Avda Valdecilla, s/n 39008 Santander, Cantabria, Spain
Departamento de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
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"apellidos" => "José Ferreiro" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212908600750?idApp=UINPBA00003Z" "url" => "/15792129/0000004400000008/v1_201305150357/S1579212908600750/v1_201305150357/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>" "titulo" => "Diffuse Alveolar Hemorrhage" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "428" "paginaFinal" => "436" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Javier Gómez-Román" "autores" => array:1 [ 0 => array:4 [ "nombre" => "José" "apellidos" => "Javier Gómez-Román" "email" => array:1 [ 0 => "apagrj@humv.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departamento de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr J.J. Gómez-Román Departamento de Anatomía Patológica Hospital Universitario Marqués de Valdecilla Avda Valdecilla, s/n 39008 Santander, Cantabria, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-09-20" "fechaAceptado" => "2007-10-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155355" "palabras" => array:3 [ 0 => "Diffuse alveolar hemorrhage" 1 => "Diagnosis" 2 => "Lung biopsy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155354" "palabras" => array:3 [ 0 => "Hemorragia alveolar difusa" 1 => "Diagnóstico" 2 => "Biopsia pulmonar" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Diffuse alveolar hemorrhage is a clinical syndrome that can be life threatening if not diagnosed and treated in time. In most cases it occurs largely as a result of small-vessel vasculitis of the lungs. The many different forms can be classified into 3 large groups: <span class="elsevierStyleItalic">a)</span> pauciimmune disease, which generally involves pulmonary capillaritis and is associated with the presence of antineutrophil cytoplasmic antibodies; <span class="elsevierStyleItalic">b)</span> syndromes caused by immune deposits, which can be detected by immunofluorescence; and <span class="elsevierStyleItalic">c)</span> a large miscellaneous group that includes drug reactions, infections, and idiopathic disease. Diagnosis is based on a combination of signs, symptoms, serology, and histology. Biopsy with video-assisted thoracoscopy should be recommended in patients with diffuse alveolar hemorrhage without known cause and with no prior diagnosis of systemic disease, in whom serology studies do not reveal conclusive data, and in general in those patients for whom there is a high level of suspicion of diffuse alveolar hemorrhage. In all such cases, the fresh biopsy material should be sent to the pathology laboratory for preparation of frozen sections to be used for immunofluorescence.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Las hemorragias alveolares difusas son cuadros clínicos que pueden ser catastróficos si no se diagnostican y tratan a tiempo. Suelen estar causadas en gran parte por vasculitis de vasos pequeños pulmonares. Existen 3 grandes grupos: <span class="elsevierStyleItalic">a)</span> las pauciinmunitarias, generalmente asociadas a capilaritis y anticuerpos citoplásmicos antineutrófilos; <span class="elsevierStyleItalic">b)</span> las producidas por depósitos inmunológicos, que pueden detectarse mediante inmunofluorescencia, y <span class="elsevierStyleItalic">c)</span> un gran grupo misceláneo, que incluye toxicidad por fármacos, infecciones y causas idiopáticas. El diagnóstico se basa en la integración de signos, síntomas, estudios serológicos y morfológicos. Se debe recomendar la realización de una biopsia por videotoracoscopia en los pacientes con hemorragia alveolar difusa de causa inexplicada, sin un diagnóstico previo de enfermedad sistémica, en la que los estudios serológicos no proporcionan datos concluyentes, y en general en aquellos pacientes con un elevado índice de sospecha de que estén desarrollando una hemorragia alveolar difusa. En todos estos casos, la biopsia debe remitirse en fresco a los servicios de anatomía patológica para permitir la congelación de un fragmento tisular, que será utilizado para el estudio por inmunofluorescencia.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This review was presented in part as a paper at the XXV SOCALPAR Congress in Segovia, Spain, in May 2006.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:49 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute lung injury as initial manifestation of diffuse alveolar hemorrhage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E Fernández Fabrellas" 1 => "J Blanquer Olivas" 2 => "R Blanquer Olivas" 3 => "M Simó Mompó" 4 => "E Chiner Vives" 5 => "F Ruiz Montalt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "An Med Interna" "fecha" => "1999" "volumen" => "16" "paginaInicial" => "281" "paginaFinal" => "284" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10422296" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nomenclature of systemic vasculitides. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 5 | 11 |
| 2024 October | 40 | 45 | 85 |
| 2024 September | 47 | 52 | 99 |
| 2024 August | 60 | 54 | 114 |
| 2024 July | 29 | 62 | 91 |
| 2024 June | 50 | 83 | 133 |
| 2024 May | 59 | 57 | 116 |
| 2024 April | 40 | 58 | 98 |
| 2024 March | 28 | 64 | 92 |
| 2024 February | 33 | 45 | 78 |
| 2024 January | 0 | 2 | 2 |
| 2023 September | 0 | 1 | 1 |
| 2023 June | 0 | 2 | 2 |
| 2023 May | 0 | 4 | 4 |
| 2023 April | 0 | 2 | 2 |
| 2023 March | 5 | 11 | 16 |
| 2023 February | 27 | 34 | 61 |
| 2023 January | 23 | 48 | 71 |
| 2022 December | 34 | 59 | 93 |
| 2022 November | 28 | 89 | 117 |
| 2022 October | 35 | 123 | 158 |
| 2022 September | 28 | 106 | 134 |
| 2022 August | 31 | 113 | 144 |
| 2022 July | 40 | 98 | 138 |
| 2022 June | 36 | 85 | 121 |
| 2022 May | 33 | 80 | 113 |
| 2022 April | 53 | 100 | 153 |
| 2022 March | 46 | 65 | 111 |
| 2022 February | 52 | 39 | 91 |
| 2022 January | 47 | 48 | 95 |
| 2021 December | 37 | 58 | 95 |
| 2021 November | 52 | 54 | 106 |
| 2021 October | 60 | 70 | 130 |
| 2021 September | 50 | 80 | 130 |
| 2021 August | 78 | 77 | 155 |
| 2021 July | 25 | 72 | 97 |
| 2021 June | 35 | 61 | 96 |
| 2021 May | 57 | 39 | 96 |
| 2021 April | 155 | 90 | 245 |
| 2021 March | 90 | 60 | 150 |
| 2021 February | 55 | 42 | 97 |
| 2021 January | 41 | 37 | 78 |
| 2020 December | 57 | 36 | 93 |
| 2020 November | 49 | 38 | 87 |
| 2020 October | 41 | 47 | 88 |
| 2020 September | 43 | 97 | 140 |
| 2020 August | 47 | 68 | 115 |
| 2020 July | 35 | 60 | 95 |
| 2020 June | 41 | 35 | 76 |
| 2020 May | 51 | 32 | 83 |
| 2020 April | 38 | 37 | 75 |
| 2020 March | 38 | 26 | 64 |
| 2020 February | 43 | 29 | 72 |
| 2020 January | 60 | 28 | 88 |
| 2019 December | 59 | 25 | 84 |
| 2019 November | 55 | 32 | 87 |
| 2019 October | 94 | 33 | 127 |
| 2019 September | 197 | 62 | 259 |
| 2019 August | 159 | 27 | 186 |
| 2019 July | 155 | 23 | 178 |
| 2019 June | 221 | 35 | 256 |
| 2019 May | 218 | 44 | 262 |
| 2019 April | 174 | 58 | 232 |
| 2019 March | 163 | 36 | 199 |
| 2019 February | 158 | 19 | 177 |
| 2019 January | 172 | 21 | 193 |
| 2018 December | 178 | 19 | 197 |
| 2018 November | 175 | 30 | 205 |
| 2018 October | 207 | 22 | 229 |
| 2018 September | 102 | 6 | 108 |
| 2018 May | 16 | 1 | 17 |
| 2018 April | 18 | 5 | 23 |
| 2018 March | 16 | 8 | 24 |
| 2018 February | 12 | 12 | 24 |
| 2018 January | 13 | 24 | 37 |
| 2017 December | 9 | 7 | 16 |
| 2017 November | 6 | 9 | 15 |
| 2017 October | 14 | 14 | 28 |
| 2017 September | 30 | 26 | 56 |
| 2017 August | 55 | 26 | 81 |
| 2017 July | 31 | 12 | 43 |
| 2017 June | 44 | 24 | 68 |
| 2017 May | 33 | 13 | 46 |
| 2017 April | 37 | 5 | 42 |
| 2017 March | 47 | 8 | 55 |
| 2017 February | 43 | 9 | 52 |
| 2017 January | 8 | 7 | 15 |
| 2016 December | 19 | 9 | 28 |
| 2016 November | 17 | 12 | 29 |
| 2016 October | 31 | 15 | 46 |
| 2016 September | 27 | 18 | 45 |
| 2016 August | 17 | 6 | 23 |
| 2016 July | 16 | 5 | 21 |
| 2016 June | 1 | 0 | 1 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 177 | 106 | 283 |
| 2015 September | 192 | 109 | 301 |
| 2015 August | 161 | 128 | 289 |
| 2015 July | 284 | 143 | 427 |
| 2015 June | 227 | 86 | 313 |
| 2015 May | 169 | 96 | 265 |
| 2015 April | 189 | 102 | 291 |
| 2015 March | 307 | 112 | 419 |
| 2015 February | 267 | 91 | 358 |
| 2015 January | 171 | 97 | 268 |
| 2014 December | 289 | 82 | 371 |
| 2014 November | 325 | 82 | 407 |
| 2014 October | 321 | 91 | 412 |
| 2014 September | 258 | 88 | 346 |
| 2014 August | 223 | 86 | 309 |
| 2014 July | 233 | 85 | 318 |
| 2014 June | 257 | 68 | 325 |
| 2014 May | 289 | 73 | 362 |
| 2014 April | 264 | 71 | 335 |
| 2014 March | 280 | 74 | 354 |
| 2014 February | 317 | 71 | 388 |
| 2014 January | 283 | 40 | 323 |
| 2013 December | 274 | 45 | 319 |
| 2013 November | 210 | 23 | 233 |
| 2013 October | 222 | 34 | 256 |
| 2013 September | 167 | 29 | 196 |
| 2013 August | 157 | 36 | 193 |
| 2013 July | 148 | 29 | 177 |
| 2013 June | 139 | 19 | 158 |
| 2013 May | 160 | 28 | 188 |
| 2013 April | 117 | 20 | 137 |
| 2013 March | 20 | 6 | 26 |
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