Skip to main content

Advertisement

SpringerLink
Log in

Proposed Pathogenesis of Diffuse Alveolar Hemorrhage in Idiopathic Pulmonary Hemosiderosis

  • DIFFUSE ALVEOLAR HEMORRHAGE
  • Published:
Lung Aims and scope Submit manuscript

Abstract

Idiopathic pulmonary hemosiderosis (IPH) is a rare disease that causes diffuse alveolar hemorrhage (DAH). The latest data suggests an immunologic origin of IPH, and a new name, immune mediated pulmonary hemosiderosis (ImPH), has been proposed. However, the exact immunologic mechanism has remained elusive for nearly eight decades despite extensive research, including detailed histopathologic analysis. Although several hypotheses have been proposed to describe the pathobiology of IPH, none of them explain the clinical and histopathologic findings conclusively. In this manuscript, we have presented a new hypothesis for the pathogenesis of DAH in IPH. We hypothesize that DAH in IPH is not immunocomplex mediated but due to histamine, eosinophilic cationic protein (ECP), and possibly vascular endothelial growth factor (VEGF). These bioactive proteins induce endothelial and alveolar epithelial damage, leading to the peri-capillary and intraalveolar escape of RBCs. The deformability of the RBC likely also plays a role. The supranormal secretion of histamine, ECP and VEGF occurs in genetically predisposed individuals with an aberrant immunologic response. The histamine is released from the basophils and possibly the mast cells in response to cytokines secreted by activated lymphocytes. The lymphocyte activation occurs after exposure to a known (gluten) or unknown antigen. The same lymphocyte-derived cytokines also induce eosinophilic degranulation of ECP and VEGF in the pulmonary circulation. We believe that our hypothesis unifies the observed clinical variabilities and histopathologic findings in IPH, and we hope that would promote future research in the field of IPH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Saha BK (2020) Idiopathic pulmonary hemosiderosis: a state of the art review. Respir Med 176:106234

    Article  PubMed  Google Scholar 

  2. Kjellman B, Elinder G, Garwicz S, Svan H (1984) Idiopathic pulmonary haemosiderosis in swedish children. Acta Paediatr 73(5):584–588

    Article  CAS  Google Scholar 

  3. Ohga S, Takahashi K, Miyazaki S, Kato H, Ueda K (1995) Idiopathic pulmonary haemosiderosis in Japan: 39 possible cases from a survey questionnaire. Eur J Pediatr 154(12):994–995

    Article  CAS  PubMed  Google Scholar 

  4. Chen X-Y, Sun J-M, Huang X-J (2017) Idiopathic pulmonary hemosiderosis in adults: review of cases reported in the latest 15 years. Clin Respir J 11(6):677–681

    Article  PubMed  Google Scholar 

  5. Ioachimescu OC, Sieber S, Kotch A (2004) Idiopathic pulmonary haemosiderosis revisited. Eur Respir J 24(1):162–169

    Article  CAS  PubMed  Google Scholar 

  6. Matsumoto S, Nakagawa S (2019) Extracorporeal membrane oxygenation for diffuse alveolar hemorrhage caused by idiopathic pulmonary hemosiderosis: a case report and a review of the literature. J Pediatr Intensive Care 8(3):181–186

    Article  PubMed  PubMed Central  Google Scholar 

  7. Gutierrez S, Shaw S, Huseni S et al (2014) Extracorporeal life support for a 5-week-old infant with idiopathic pulmonary hemosiderosis. Eur J Pediatr 173(12):1573–1576

    Article  PubMed  Google Scholar 

  8. Khorashadi L, Wu CC, Betancourt SL, Carter BW (2015) Idiopathic pulmonary haemosiderosis: spectrum of thoracic imaging findings in the adult patient. Clin Radiol 70(5):459–465

    Article  CAS  PubMed  Google Scholar 

  9. Cheah FK, Sheppard MN, Hansell DM (1993) Computed tomography of diffuse pulmonary haemorrhage with pathological correlation. Clin Radiol 48(2):89–93

    Article  CAS  PubMed  Google Scholar 

  10. Harte S, Mcnicholas WT, Donnelly SC, Dodd JD (2008) Honeycomb cysts in idiopathic pulmonary haemosiderosis: high-resolution CT appearances in two adults. BJR 81(972):295–298

    Article  Google Scholar 

  11. Saha BK, Chong WH (2021) Lung transplant to manage end-stage lung disease due to idiopathic pulmonary hemosiderosis: a review of the literature. Respir Investig 60:82

    Article  PubMed  Google Scholar 

  12. Saha BK, Chong WH, Milman NT (2021) Differentiation of idiopathic pulmonary hemosiderosis from rheumatologic and autoimmune diseases causing diffuse alveolar hemorrhage: establishing a diagnostic approach. Clin Rheumatol. https://doi.org/10.1007/s10067-021-05895-1

    Article  PubMed  Google Scholar 

  13. Saha S, Chong WH, Saha BK (2021) Unilateral diffuse alveolar hemorrhage due to selective directionality of mitral regurgitant jet in a patient with severe aortic stenosis. Cureus. 13(4):14714

    Google Scholar 

  14. Imtiaz M, Saha B, Sana Ullah U, Saha A (2019) A case of acute life-threatening pulmonary hemorrhage from synthetic cannabinoid abuse. Case Rep Pulmonol 2019:8137648

    PubMed  PubMed Central  Google Scholar 

  15. Saeed MM, Woo MS, MacLaughlin EF, Margetis MF, Keens TG (1999) Prognosis in pediatric idiopathic pulmonary hemosiderosis. Chest 116(3):721–725

    Article  CAS  PubMed  Google Scholar 

  16. Saha BK (2021) Is it time to call idiopathic pulmonary hemosiderosis by the correct name: immune-mediated pulmonary hemosiderosis? Am J Med Sci 9629(21):00006–00009

    Google Scholar 

  17. Taytard J, Nathan N, de Blic J et al (2013) New insights into pediatric idiopathic pulmonary hemosiderosis: the French RespiRare(®) cohort. Orphanet J Rare Dis 8:161

    Article  PubMed  PubMed Central  Google Scholar 

  18. Saha BK, Milman NT (2020) Idiopathic pulmonary hemosiderosis: a review of the treatments used during the past 30 years and future directions. Clin Rheumatol. https://doi.org/10.1007/s10067-020-05507-4

    Article  PubMed  PubMed Central  Google Scholar 

  19. Chin CIC, Kohn SL, Keens TG, Margetis MF, Kato RM (2015) A physician survey reveals differences in management of idiopathic pulmonary hemosiderosis. Orphanet J Rare Dis 10:98

    Article  PubMed  PubMed Central  Google Scholar 

  20. Saha BK, Milman NT (2021) Short review of liposteroid: a novel targeted glucocorticoid preparation for treatment of autoimmune and inflammatory diseases. Prague Med Rep 122(4):257–268

    Article  PubMed  Google Scholar 

  21. Kayser K, Plodziszewska M, Waitr E, Slodkowska J, Altiner M, Gabius HJ (1998) Diffuse pulmonary hemosiderosis after exposure to pesticides: a case report. Respiration 65(3):214–218

    Article  CAS  PubMed  Google Scholar 

  22. Dearborn DG, Yike I, Sorenson WG, Miller MJ, Etzel RA (1999) Overview of investigations into pulmonary hemorrhage among infants in Cleveland, Ohio. Environ Health Perspect 107(Suppl 3):495–499

    Article  PubMed  PubMed Central  Google Scholar 

  23. Dearborn DG, Smith PG, Dahms BB et al (2002) Clinical profile of 30 infants with acute pulmonary hemorrhage in Cleveland. Pediatrics 110(3):627–637

    Article  PubMed  Google Scholar 

  24. Torres MJ, Girón MD, Corzo JL et al (1996) Release of inflammatory mediators after cow’s milk intake in a newborn with idiopathic pulmonary hemosiderosis. J Allergy Clin Immunol 98(6 Pt 1):1120–1123

    Article  CAS  PubMed  Google Scholar 

  25. Moissidis I, Chaidaroon D, Vichyanond P, Bahna SL (2005) Milk-induced pulmonary disease in infants (Heiner syndrome). Pediatr Allergy Immunol 16(6):545–552

    Article  PubMed  Google Scholar 

  26. Heiner DC, Sears JW (1960) Chronic respiratory disease associated with multiple circulating precipitins to cow’s milk. Am J Dis Child 100(4):500–502

    Google Scholar 

  27. Li Y-T, Guo Y-X, Cai L-M et al (2017) Methylprednisolone pulse therapy rescued life-threatening pulmonary hemorrhage due to idiopathic pulmonary hemosiderosis. Am J Emerg Med 35(11):1786

    Article  PubMed  Google Scholar 

  28. Zhang Y, Luo F, Wang N, Song Y, Tao Y (2019) Clinical characteristics and prognosis of idiopathic pulmonary hemosiderosis in pediatric patients. J Int Med Res 47(1):293–302

    Article  PubMed  Google Scholar 

  29. Colombo JL, Stolz SM (1992) Treatment of life-threatening primary pulmonary hemosiderosis with cyclophosphamide. Chest 102:959

    Article  CAS  PubMed  Google Scholar 

  30. Naithani R, Chandra J, Singh V, Kumar V, Dubey NK (2006) Life threatening exacerbation in idiopathic pulmonary hemosiderosis salvaged by cyclophosphamide infusion. Indian J Chest Dis Allied Sci 48(4):287–289

    PubMed  Google Scholar 

  31. Kiper N, Göçmen A, Özçelik U, Dilber E, Anadol D (1999) Long-term clinical course of patients with idiopathic pulmonary hemosiderosis (1979–1994): prolonged survival with low-dose corticosteroid therapy. Pediatr Pulmonol 27(3):180–184

    Article  CAS  PubMed  Google Scholar 

  32. Soergel KH, Sommers SC (1962) Idiopathic pulmonary hemosiderosis and related syndromes. Am J Med 32(4):499–511

    Article  Google Scholar 

  33. Yanagihara T, Yamamoto Y, Hamada N et al (2018) Recurrent idiopathic pulmonary hemosiderosis after long-term remission presented with Sjogren’s syndrome: idiopathic no more? Respir Med Case Rep 25:68–72

    PubMed  PubMed Central  Google Scholar 

  34. Iijima N, Torii Y, Ito S et al (1988) A case of idiopathic pulmonary hemosiderosis recurrent after remission of fifteen years and associated with Sjögren’s syndrome. Nihon Kyobu Shikkan Gakkai Zasshi 26(11):1191–1194

    CAS  PubMed  Google Scholar 

  35. Stainer A, Rice A, Devaraj A et al (2019) Diffuse alveolar haemorrhage associated with subsequent development of ANCA positivity and emphysema in three young adults. BMC Pulm Med 19(1):185

    Article  PubMed  PubMed Central  Google Scholar 

  36. Freitas A, Senra V, Marinho A, Guedes M (2015) Chronic alveolar haemorrhage in a paediatric patient: a diagnostic and treatment challenge. BMJ Case Rep 2015:1

    Article  Google Scholar 

  37. Corrin B, Jagusch M, Dewar A et al (1987) Fine structural changes in idiopathic pulmonary haemosiderosis. J Pathol 153(3):249–256

    Article  CAS  PubMed  Google Scholar 

  38. Hyatt RW, Adelstein ER, Halazun JF, Lukens JN (1972) Ultrastructure of the lung in idiopathic pulmonary hemosiderosis. Am J Med 52(6):822–829

    Article  CAS  PubMed  Google Scholar 

  39. Yeager H, Powell D, Weinberg RM, Bauer H, Bellanti JA, Katz S (1976) Idiopathic pulmonary hemosiderosis: ultrastructural studies and responses to azathioprine. Arch Intern Med 136(10):1145–1149

    Article  PubMed  Google Scholar 

  40. Gonzalez-Crussi F, Hull MT, Grosfeld JL (1976) Idiopathic pulmonary hemosiderosis: evidence of capillary basement membrane abnormality. Am Rev Respir Dis 114(4):689–698

    CAS  PubMed  Google Scholar 

  41. Perelman S, Dupuy C, Bourrillon A (1992) The association of pulmonary hemosiderosis and celiac disease: apropos of a new case in a child. Ann Pediatr (Paris) 39(3):185–188

    CAS  Google Scholar 

  42. Sethi GR, Singhal KK, Puri AS, Mantan M (2011) Benefit of gluten-free diet in idiopathic pulmonary hemosiderosis in association with celiac disease. Pediatr Pulmonol 46(3):302–305

    Article  PubMed  Google Scholar 

  43. Khemiri M, Ouederni M, Khaldi F, Barsaoui S (2008) Screening for celiac disease in idiopathic pulmonary hemosiderosis. Gastroenterol Clin Biol 32(8–9):745–748

    Article  CAS  PubMed  Google Scholar 

  44. Alimi A, Taytard J, Abou Taam R et al (2018) Pulmonary hemosiderosis in children with Down syndrome: a national experience. Orphanet J Rare Dis 13(1):60

    Article  PubMed  PubMed Central  Google Scholar 

  45. Watanabe H, Ayusawa M, Kato M et al (2015) Idiopathic pulmonary hemosiderosis complicated by Down syndrome. Pediatr Int 57(5):1009–1012

    Article  PubMed  Google Scholar 

  46. Pellegrini FP, Marinoni M, Frangione V et al (2012) Down syndrome, autoimmunity and T regulatory cells. Clin Exp Immunol 169(3):238–243

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Elliott ML, Kuhn C (1970) Idiopathic pulmonary hemosiderosis. Am Rev Respir Dis 102(6):895–904

    CAS  PubMed  Google Scholar 

  48. Lemley DE, Katz P (1986) Rheumatoid-like arthritis presenting as idiopathic pulmonary hemosiderosis: a report and review of the literature. J Rheumatol 13(5):954–957

    CAS  PubMed  Google Scholar 

  49. Irwin RS, Cottrell TS, Hsu KC, Griswold WR, Thomas HM III (1974) Idiopathic pulmonary hemosiderosis: an electron microscopic and immunofluorescen. Chest 65(1):41–45

    Article  CAS  PubMed  Google Scholar 

  50. Donald KJ, Edwards RL, McEvoy JD (1975) Alveolar capillary basement membrane lesions in Goodpasture’s syndrome and idiopathic pulmonary hemosiderosis. Am J Med 59(5):642–649

    Article  CAS  PubMed  Google Scholar 

  51. Tedeschi A, Lorini M, Giannini S, Ciceri L, Suli C, Airaghi L (2001) Serum histamine-releasing activity in a patient with idiopathic pulmonary haemosiderosis. Allergol Immunopathol 29(6):281–283

    Article  CAS  Google Scholar 

  52. Saha BK, Bonnier A, Chenna P, Milman NT (2022) Prevalence of autoantibodies in pediatric patients with idiopathic pulmonary hemosiderosis: a scoping review of the literature in the period 1980–2021. Clin Rheumatol. https://doi.org/10.1007/s10067-021-06029-3

    Article  PubMed  Google Scholar 

  53. Hendrickx GFM, Somers K, Vandenplas Y (2011) Lane-Hamilton syndrome: case report and review of the literature. Eur J Pediatr 170(12):1597–1602

    Article  PubMed  Google Scholar 

  54. Saha BK, Saha S, Bonnier A, Saha BN (2022) Association between idiopathic pulmonary hemosiderosis and celiac disease in pediatric patients: A scoping review of the literature over the past 50 years. Pediatr Pulmonol. https://doi.org/10.1002/ppul.25847

    Article  PubMed  Google Scholar 

  55. Low FN (1953) The pulmonary alveolar epithelium of laboratory mammals and man. Anat Rec 117(2):241–263

    Article  CAS  PubMed  Google Scholar 

  56. Gehr P, Bachofen M, Weibel ER (1978) The normal human lung: ultrastructure and morphometric estimation of diffusion capacity. Respir Physiol 32(2):121–140

    Article  CAS  PubMed  Google Scholar 

  57. West JB, Mathieu-Costello O (1995) Vulnerability of pulmonary capillaries in heart disease. Circulation 92(3):622–631

    Article  CAS  PubMed  Google Scholar 

  58. Fisher RF, Wakely J (1976) The elastic constants and ultrastructural organization of a basement membrane (lens capsule). Proc R Soc Lond B Biol Sci 193(1113):335–358

    Article  CAS  PubMed  Google Scholar 

  59. Saha BK, Chong WH (2021) Diffuse alveolar hemorrhage in cardiac diseases. Lung. https://doi.org/10.1007/s00408-021-00433-x

    Article  PubMed  Google Scholar 

  60. West JB, Mathieu-Costello O (1992) Strength of the pulmonary blood-gas barrier. Respir Physiol 88(1):141–148

    Article  CAS  PubMed  Google Scholar 

  61. Gil J, Bachofen H, Gehr P, Weibel ER (1979) Alveolar volume-surface area relation in air- and saline-filled lungs fixed by vascular perfusion. J Appl Physiol Respir Environ Exerc Physiol 47(5):990–1001

    CAS  PubMed  Google Scholar 

  62. Fein A, Grossman RF, Jones JG et al (1979) The value of edema fluid protein measurement in patients with pulmonary edema. Am J Med 67(1):32–38

    Article  CAS  PubMed  Google Scholar 

  63. Pietra GG, Szidon JP, Leventhal MM, Fishman AP (1969) Hemoglobin as a tracer in hemodynamic pulmonary edema. Science 166(3913):1643–1646

    Article  CAS  PubMed  Google Scholar 

  64. West JB, Tsukimoto K, Mathieu-Costello O, Prediletto R (1991) Stress failure in pulmonary capillaries. J Appl Physiol 70(4):1731–1742

    Article  CAS  PubMed  Google Scholar 

  65. Wallez Y, Huber P (2008) Endothelial adherens and tight junctions in vascular homeostasis, inflammation and angiogenesis. Biochim Biophys Acta 1778(3):794–809

    Article  CAS  PubMed  Google Scholar 

  66. Ashina K, Tsubosaka Y, Nakamura T et al (2015) Histamine induces vascular hyperpermeability by increasing blood flow and endothelial barrier disruption in vivo. PLoS ONE 10:7

    Article  CAS  Google Scholar 

  67. Saha BK, Burns SL (2020) The story of nitric oxide, sepsis and methylene blue: a comprehensive pathophysiologic review. Am J Med Sci 9629:30249

    Google Scholar 

  68. Histamine Receptor - an overview|ScienceDirect Topics [Internet]. https://www.sciencedirect.com/topics/neuroscience/histamine-receptor

  69. Seifert R, Strasser A, Schneider EH, Neumann D, Dove S, Buschauer A (2013) Molecular and cellular analysis of human histamine receptor subtypes. Trends Pharmacol Sci 34(1):33–58

    Article  CAS  PubMed  Google Scholar 

  70. Hubbard KB, Hepler JR (2006) Cell signalling diversity of the Gqalpha family of heterotrimeric G proteins. Cell Signal 18(2):135–150

    Article  CAS  PubMed  Google Scholar 

  71. Mikelis CM, Simaan M, Ando K et al (2015) RhoA and ROCK mediate histamine-induced vascular leakage and anaphylactic shock. Nat Commun 6(1):6725

    Article  CAS  PubMed  Google Scholar 

  72. Geerten A, van Nieuw P, Richard D, Mario AV, van Hinsbergh VWM (1998) Transient and prolonged increase in endothelial permeability induced by histamine and thrombin. Circ Res 83(11):1115–1123

    Article  Google Scholar 

  73. De Bisschop M-B, Bellou A (2012) Anaphylaxis. Curr Opin Crit Care 18(4):308–317

    Article  PubMed  Google Scholar 

  74. Ishii S, Kuwaki T, Nagase T et al (1998) Impaired anaphylactic responses with intact sensitivity to endotoxin in mice lacking a platelet-activating factor receptor. J Exp Med 187(11):1779–1788

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Cohen S (1999) Idiopathic pulmonary hemosiderosis. Am J Med Sci 317(1):67–74

    Article  CAS  PubMed  Google Scholar 

  76. Davoine F, Lacy P (2014) Eosinophil cytokines, chemokines, and growth factors: emerging roles in immunity. Front Immunol 5:4225839

    Article  CAS  Google Scholar 

  77. Trautmann A, Schmid-Grendelmeier P, Krüger K et al (2002) T cells and eosinophils cooperate in the induction of bronchial epithelial cell apoptosis in asthma. J Allergy Clin Immunol 109(2):329–337

    Article  PubMed  Google Scholar 

  78. Navarro S, Aleu J, Jiménez M, Boix E, Cuchillo CM, Nogués MV (2008) The cytotoxicity of eosinophil cationic protein/ribonuclease 3 on eukaryotic cell lines takes place through its aggregation on the cell membrane. Cell Mol Life Sci 65(2):324–337

    Article  CAS  PubMed  Google Scholar 

  79. Chang K-C, Lo C-W, Fan T et al (2010) TNF-α mediates eosinophil cationic protein-induced apoptosis in BEAS-2B cells. BMC Cell Biol 11:6

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  80. Diez-Silva M, Dao M, Han J, Lim C-T, Suresh S (2010) Shape and biomechanical characteristics of human red blood cells in health and disease. MRS Bull 35(5):382–388

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Quinn DJ, Pivkin I, Wong SY et al (2011) Combined simulation and experimental study of large deformation of red blood cells in microfluidic systems. Ann Biomed Eng 39(3):1041–1050

    Article  PubMed  Google Scholar 

  82. Ferrara N (2001) Role of vascular endothelial growth factor in regulation of physiological angiogenesis. Am J Physiol Cell Physiol 280(6):C1358-1366

    Article  CAS  PubMed  Google Scholar 

  83. Voelkel NF, Vandivier RW, Tuder RM (2006) Vascular endothelial growth factor in the lung. Am J Physiol Lung Cell Mol Physiol 290(2):L209-221

    Article  CAS  PubMed  Google Scholar 

  84. Barratt S, Medford AR, Millar AB (2014) Vascular endothelial growth factor in acute lung injury and acute respiratory distress syndrome. RES 87(4):329–342

    CAS  Google Scholar 

  85. Nishigaki Y, Fujiuchi S, Yamazaki Y et al (2003) Increased vascular endothelial growth factor in acute eosinophilic pneumonia. Eur Respir J 21(5):774–778

    Article  CAS  PubMed  Google Scholar 

  86. de Paulis A, Prevete N, Fiorentino I et al (2006) Expression and functions of the vascular endothelial growth factors and their receptors in human basophils. J Immunol 177(10):7322–7331

    Article  PubMed  Google Scholar 

  87. Boesiger J, Tsai M, Maurer M et al (1998) Mast cells can secrete vascular permeability factor/ vascular endothelial cell growth factor and exhibit enhanced release after immunoglobulin e-dependent upregulation of Fcε receptor i expression. J Exp Med 188(6):1135–1145

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. Grützkau A, Krüger-Krasagakes S, Baumeister H et al (1998) Synthesis, storage, and release of vascular endothelial growth Factor/Vascular Permeability Factor (VEGF/VPF) by Human mast cells: implications for the biological significance of VEGF206. MBoC 9(4):875–884

    Article  PubMed  PubMed Central  Google Scholar 

  89. Ladzinski A, Mehta A, Dykstra B (2020) Diffuse alveolar hemorrhage due to eosinophilic pneumonia. Chest 158(4):A1149

    Article  Google Scholar 

  90. Song C, Ma H, Yao C, Tao X, Gan H (2012) Alveolar macrophage-derived vascular endothelial growth factor contributes to allergic airway inflammation in a mouse asthma model. Scand J Immunol 75(6):599–605

    Article  CAS  PubMed  Google Scholar 

  91. Roberts WG, Palade GE (1995) Increased microvascular permeability and endothelial fenestration induced by vascular endothelial growth factor. J Cell Sci 108(6):2369–2379

    Article  CAS  PubMed  Google Scholar 

  92. Le Cras TD, Spitzmiller RE, Albertine KH, Greenberg JM, Whitsett JA, Akeson AL (2004) VEGF causes pulmonary hemorrhage, hemosiderosis, and air space enlargement in neonatal mice. Am J Physiol Lung Cell Mol Physiol 287(1):L134-142

    Article  PubMed  Google Scholar 

  93. Wu NZ, Baldwin AL (1992) Transient venular permeability increase and endothelial gap formation induced by histamine. Am J Physiol Heart Circ Physiol 262(4):H1238–H1247

    Article  CAS  Google Scholar 

  94. Lam SM (1998) Acute pulmonary hemorrhage following a honeybee sting: a case report. J Microbiol Immunol Infect 31(2):133–136

    CAS  PubMed  Google Scholar 

  95. Sheybani A, Agarwal HS. Pulmonary Hemorrhage in Food-Induced Anaphylaxis in a Pediatric Patient . In: D51. PEDIATRIC CASES II, American Thoracic Society, A7266–A7266 (2016) [cited 2021 Feb 28]. https://www.atsjournals.org/doi/abs/https://doi.org/10.1164/ajrccm-conference.2016.193.1_MeetingAbstracts.A7266.

  96. Pierce GB, Nakane PK (1969) Basement membranes: synthesis and deposition in response to cellular injury. Lab Invest 21(1):27–41

    CAS  PubMed  Google Scholar 

  97. Al-Adhoubi NK, Bystrom J (2020) Systemic lupus erythematosus and diffuse alveolar hemorrhage, etiology and novel treatment strategies. Lupus 29(4):355–363

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Zamora MR, Warner ML, Tuder R, Schwarz MI (1997) Diffuse alveolar hemorrhage and systemic lupus erythematosus: clinical presentation, histology, survival, and outcome. Medicine 76(3):192–202

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, Ozarks Medical Center, 1100 Kentucky Avenue, West Plains, Missouri, MO, 65775, USA

    Biplab K. Saha

  2. Department of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY, USA

    Woon H. Chong

  3. Department of Internal Medicine, Bangladesh Medical College, Dhaka, Bangladesh

    Santu Saha

  4. New York Institute of Technology College of Osteopathic Medicine, Arkansas State University, Arkansas, USA

    Alexis Aiman

  5. Department of Critical Care Nursing, Goldfarb School of Nursing, Barnes Jewish College, St. Louis, MO, USA

    Alyssa Bonnier

Authors
  1. Biplab K. Saha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Woon H. Chong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Santu Saha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexis Aiman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alyssa Bonnier
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors were involved in planning, data collection, preparation of the initial and final manuscript.

Corresponding author

Correspondence to Biplab K. Saha.

Ethics declarations

Conflict of interest

The authors have not disclosed any competing interests.

Ethical Approval

Not required.

Informed Consent

Not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Saha, B.K., Chong, W.H., Saha, S. et al. Proposed Pathogenesis of Diffuse Alveolar Hemorrhage in Idiopathic Pulmonary Hemosiderosis. Lung 200, 205–215 (2022). https://doi.org/10.1007/s00408-022-00523-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-022-00523-4

Keywords

Search

Navigation