Diffuse Alveolar Hemorrhage in Coumarin Users: A Fibrosing Interstitial Pneumonia Trigger?
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Fibrosing interstitial pneumonias (IPs) include idiopathic pulmonary fibrosis (IPF) and nonspecific interstitial pneumonia (NSIP). It has been suggested that oxidative damage plays a role in the pathophysiology of idiopathic interstitial pneumonias. Diffuse alveolar hemorrhage (DAH) can cause oxidative stress. Accordingly, we hypothesized that episodes of DAH might trigger fibrosing IP development.
Patients using coumarins with confirmed DAH were retrospectively gathered during a 9 year period and reviewed for the development of IPF or fibrosing NSIP.
A total of 65 patients with DAH could finally be included, 31 (48 %) of whom subsequently developed a fibrosing IP. The majority of these 31 patients developed the fibrosing IP within 3 years after DAH confirmation. A total of 41 (63 %) patients died within 3.0 ± 0.9 (range 1.3–4.7) years after the DAH diagnosis had been confirmed. Twenty-two of the deceased (54 %) had finally developed fibrosing IP.
Almost half of the patients with established episodes of DAH developed fibrosing IP; therefore it seems that DAH might be a trigger for the development of fibrosing IP. This observation warrants prospective studies to further evaluate the clinical impact of these findings.
- Diffuse Alveolar Hemorrhage in Coumarin Users: A Fibrosing Interstitial Pneumonia Trigger?
Volume 191, Issue 1 , pp 53-59
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Diffuse alveolar hemorrhage
- Fibrosing interstitial pneumonia
- Oxidative stress
- Industry Sectors
- Author Affiliations
- 1. Department of Clinical Chemistry, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
- 2. Department of Radiology, University Hospital Gasthuisberg, Leuven, Belgium
- 3. Department of Toxicology, University Maastricht, Maastricht, The Netherlands
- 4. Faculty of Health, Medicine and Life Sciences, University Maastricht, P.O. Box 3100, 6202 NC, Maastricht, The Netherlands
- 5. Department of Interstitial Lung Diseases, Hospital Gelderse Vallei, Ede, The Netherlands