Diagnosis of pulmonary hemorrhage in the immunocompromised host. 1987

F W Kahn, and J M Jones, and D M England

The efficacy of bronchoalveolar lavage (BAL) in diagnosing pulmonary hemorrhage was studied in 51 immunosuppressed patients with new pulmonary infiltrates. Similar studies were performed in a control group of 8 nonimmunocompromised patients. Hemosiderin content in Prussian-blue-stained alveolar macrophages obtained by BAL was graded using a numerical scale. This "hemosiderin score" correlated closely with the degree of hemorrhage seen in corresponding histologic sections in the 26 patients from whom a lung biopsy or autopsy specimen was available. Severe pulmonary hemorrhage was ultimately diagnosed in 14 cases, and a mild degree of hemorrhage was found in an additional 19 cases. Thrombocytopenia and invasive fungal infections were statistically associated with severe hemorrhage, as was an increased percentage of alveolar macrophages in the BAL sample. This study demonstrates the efficacy of BAL in diagnosing occult pulmonary hemorrhage in the immunosuppressed host and highlights risk factors associated with hemorrhage in this setting.

UI MeSH Term Description Entries
D007153 Immunologic Deficiency Syndromes Syndromes in which there is a deficiency or defect in the mechanisms of immunity, either cellular or humoral. Antibody Deficiency Syndrome,Deficiency Syndrome, Immunologic,Deficiency Syndromes, Antibody,Deficiency Syndromes, Immunologic,Immunologic Deficiency Syndrome,Immunological Deficiency Syndromes,Antibody Deficiency Syndromes,Deficiency Syndrome, Antibody,Deficiency Syndrome, Immunological,Deficiency Syndromes, Immunological,Immunological Deficiency Syndrome,Syndrome, Antibody Deficiency,Syndrome, Immunologic Deficiency,Syndrome, Immunological Deficiency,Syndromes, Antibody Deficiency,Syndromes, Immunologic Deficiency,Syndromes, Immunological Deficiency
D007507 Therapeutic Irrigation The washing of a body cavity or surface by flowing water or solution for therapy or diagnosis. Douching,Lavage,Douchings,Irrigation, Therapeutic,Irrigations, Therapeutic,Lavages,Therapeutic Irrigations
D008171 Lung Diseases Pathological processes involving any part of the LUNG. Pulmonary Diseases,Disease, Pulmonary,Diseases, Pulmonary,Pulmonary Disease,Disease, Lung,Diseases, Lung,Lung Disease
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011650 Pulmonary Alveoli Small polyhedral outpouchings along the walls of the alveolar sacs, alveolar ducts and terminal bronchioles through the walls of which gas exchange between alveolar air and pulmonary capillary blood takes place. Alveoli, Pulmonary,Alveolus, Pulmonary,Pulmonary Alveolus
D001980 Bronchi The larger air passages of the lungs arising from the terminal bifurcation of the TRACHEA. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into BRONCHIOLES and PULMONARY ALVEOLI. Primary Bronchi,Primary Bronchus,Secondary Bronchi,Secondary Bronchus,Tertiary Bronchi,Tertiary Bronchus,Bronchi, Primary,Bronchi, Secondary,Bronchi, Tertiary,Bronchus,Bronchus, Primary,Bronchus, Secondary,Bronchus, Tertiary
D001999 Bronchoscopy Endoscopic examination, therapy or surgery of the bronchi. Bronchoscopic Surgical Procedures,Surgical Procedures, Bronchoscopic,Bronchoscopic Surgery,Surgery, Bronchoscopic,Bronchoscopic Surgeries,Bronchoscopic Surgical Procedure,Bronchoscopies,Surgeries, Bronchoscopic,Surgical Procedure, Bronchoscopic
D005336 Fiber Optic Technology The technology of transmitting light over long distances through strands of glass or other transparent material. Fiber Optic Technologies,Optic Technologies, Fiber,Optic Technology, Fiber,Technologies, Fiber Optic,Technology, Fiber Optic
D006402 Hematologic Diseases Disorders of the blood and blood forming tissues. Blood Diseases,Hematological Diseases,Blood Disease,Disease, Blood,Disease, Hematologic,Disease, Hematological,Diseases, Blood,Diseases, Hematologic,Diseases, Hematological,Hematologic Disease,Hematological Disease
D006470 Hemorrhage Bleeding or escape of blood from a vessel. Bleeding,Hemorrhages

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