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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

More patients with cystic fibrosis are surviving into adulthood. Primary care physicians need a basic understanding of adult cystic fibrosis and the evaluation of patients with acute decompensation. Respiratory decompensation is usually the result of infective agents, including Pseudomonas aeruginosa, Stentrophomonas maltophilia and Burkholderia cepacia, and requires treatment with intravenous antibiotics. If symptoms worsen, the possibility of another complication, such as pneumothorax, hemoptysis, mycobacterial infection and allergic bronchopulmonary aspergillosis, must be considered. Family physicians can play an important role in the birth to adult care of patients with cystic fibrosis.
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PMID:Treatment of cystic fibrosis in adults. 881 73

The course of a 12-year-old girl with cystic fibrosis (CF) and with recurrent hemoptysis since age 8 years is described. Conservative measures failed to control her bleeding. Hemoptysis was only partially controlled by repeated bronchial arterial embolizations. However, the addition of tranexamic acid (TXA) resulted in complete cessation of bleeding. Attempts to withdraw TXA therapy resulted in recurrence of hemoptysis; this patient has, therefore, been continuously maintained on this therapy for the past 4 years. No side effects of long-term TXA treatment have been noted.
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PMID:Treatment of recurrent hemoptysis in a child with cystic fibrosis by repeated bronchial artery embolizations and long-term tranexamic acid. 890 89

The case history is presented of a young woman with cystic fibrosis and life threatening haemoptysis. Angiography revealed enlarged bronchial vessels, one of which supplied the contralateral lung. Transverse myelitis developed following bronchial artery embolisation but recovery was rapid and nearly complete. Haemoptysis did not recur during four years of follow up.
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PMID:Transverse myelitis: a reversible complication of bronchial artery embolisation in cystic fibrosis. 903 51

Acute rejection after lung transplantation occurs commonly and is usually characterized histologically by a perivascular mononuclear infiltrate. We report five cases of pulmonary capillaritis with a histologic appearance distinct from typical rejection, occurring in patients ranging in age from 18 to 45 years, with a variety of underlying diseases including alpha1 antitrypsin deficiency, pulmonary hypertension, cystic fibrosis, and rheumatoid arthritis. Four of the five patients had alveolar hemorrhage histologically, and two had frank hemoptysis. Time of onset ranged from 3 weeks to many months after transplantation. Three cases were fulminant, and there were two deaths. In only one case, with methicillin-resistant Staphylococcus aureus bronchitis, could infection be established. All were treated with intensification of immunosuppressive therapy. Plasmapheresis was carried out in two cases and coincided with temporary improvement, but its efficacy was questionable because of concurrent immunosuppressive therapy. Two had recurrent biopsy-proven acute rejection within 6 weeks of treatment, and one had recurrent severe pulmonary hemorrhage that abated with total lymphoid irradiation. Our experience suggests that pulmonary capillaritis in lung transplant recipients can be an acute, fatal illness with the potential for recurrence in the survivors. We speculate that it represents a form of acute vascular rejection. Early pathologic diagnosis and aggressive immunosuppressive therapy are recommended. Although a humoral component was not documented, the possible response to plasmapheresis requires continued evaluation.
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PMID:Pulmonary capillaritis: a possible histologic form of acute pulmonary allograft rejection. 958 87

Hemoptysis is common in patients with cystic fibrosis (CF). Bleeding may vary in severity, ranging from minor blood-streaking of sputum to expectoration of significant quantities of blood. Major hemoptysis, defined as bleeding greater than 240 ml/24 h, represents a medical emergency. Bronchial artery embolization (BAE) is one of the treatment options for hemoptysis. We reviewed the 10-yr experience at the University of North Carolina Hospitals in the treatment of hemoptysis by BAE. Eighteen patients with CF were hospitalized on 29 occasions and underwent 36 BAE procedures for the control of hemoptysis. Most patients (n = 11) had very severe lung disease (FEV1 < 35%) with a high incidence (n = 9, 50%) of multi-drug-resistant bacteria. Fifteen patients (n = 33 procedures) were followed for a mean of approximately 22 mo after BAE. The overall efficacy of BAE for initial control of hemoptysis was 75% (n = 22) after one session, 89% (n = 26) after two sessions, and 93% (n = 27) after three sessions. The overall recurrence rate per episode was 46% (12/26 presentations in four patients) with a mean time for recurrence of approximately 12 mo. There was a high incidence (75%) of bleeding from nonbronchial systemic collateral vessels among patients (n = 7) who had undergone a previous BAE. There were two deaths associated with massive hemoptysis despite BAE. Three patients had transient neurologic deficits during BAE. We concluded that BAE is a relatively safe and effective means of treating significant hemoptysis in patients with CF.
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PMID:Bronchial artery embolization for the treatment of hemoptysis in patients with cystic fibrosis. 962 Sep 32

The authors summarized the results of ten years care of adult patients with cystic fibrosis (CF). They treated a total of 45 patients incl. 26 men and 19 women. Nineteen patients (42%) died. The most frequent cause of admission to hospital was respiratory infection (84%), planned antibiotic treatment (6.5%), pneumothorax (6%) and haemoptysis (4%). In all patients impaired ventilation of the obstructive type was found. The mean annual decline of FEV1 was 0.173 +/- 0.194 l, VC 0.303 +/- 0.323 l. The authors did not find a significant difference between live and dead patients. The mean annual increase of PaCO2 was 0.5 +/- 0.87 kPa, the mean annual decrease of PaO2 was 0.6 +/- 0.96 kPa. The difference of values in dead and live patients was significant. CF still remains an incurable disease. It is, however, possible by comprehensive treatment to prolong the patients life and to improve its quality.
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PMID:[10 years' of care of adult patients with cystic fibrosis]. 965 May 3

A female patient, 28 years old, with massive haemoptysis as a complication of cystic fibrosis, is described. Cystic fibrosis is a systemic disease with common pulmonary manifestations. Chronic inflammatory process causes the proliferation of bronchial arteries, and their erosion is followed by bleeding. Transitory haemoptysis is common in patients with cystic fibrosis, but massive haemoptysis is a rare complication of this disease.
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PMID:[Massive hemoptysis as a rare complication in a patient with cystic fibrosis]. 992 Oct 28

Hemoptysis in children are infrequent and often self-limiting. They are a manifestation of the broader spectrum of pulmonary haemorrhage. Diffuse pulmonary haemorrhages are often associated with diseases of other organs (cardiopathies, systemic diseases). Focal haemorrhages have multiple aetiologies, dominated by bronchopulmonary infections and cystic fibrosis. Fiberoptic bronchoscopy allows one to localise the bleeding, look for local causes and diagnose pulmonary hemosiderosis by BAL. For local lesions and if the medical management fails, bronchial arteriography is indicated to perform the embolisation of the bleeding vessels.
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PMID:[Management of hemoptysis in children]. 1079 51

Bronchial artery embolization is an effective treatment for patients with hemoptysis. Serious complications are rare, but may occur if the arterial supply to other structures is compromised. We present a case of unilateral diaphragmatic paralysis following bronchial artery embolization in a patient with cystic fibrosis. We believe that the diaphragmatic paralysis was due to the inadvertent obstruction of the left pericardiacophrenic artery during the embolization procedure, with compromise of the phrenic nerve blood supply. This resulted in a significant loss of lung function in our patient, who did not recover despite the subsequent return of diaphragmatic function.
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PMID:Unilateral diaphragmatic paralysis following bronchial artery embolization for hemoptysis. 1089 96

Hemoptysis is an infrequent symptom in childhood and potentially life threatening. The most common causes in this age group are bronchiectasis secondary to cystic fibrosis, cardiovascular and pulmonary congenital anomalies and a miscellaneous group of causes including retained intrabronchial aspirated foreign bodies. We report a previously healthy 5-year-old girl with recurrent pneumonias associated with episodes of hemoptysis. She was admitted in our institution to investigate the persistence of hemoptysis. Based on clinical history, aspiration of a vegetal foreign body was postulated as the etiology and it was confirmed in the pathological examination after surgical exploration, with pulmonary lobe resection. The importance of a good history taking in pediatric hemoptysis is emphasized.
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PMID:[Vegetal foreign body in the airway: an unusual cause of hemoptysis in childhood. Clinical case]. 1096 76


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