A 27-year-old female presented with diffuse alveolar haemorrhage due to breast angiosarcoma with lung metastasis

Diffuse alveolar hemorrhage from metastatic cardiac angiosarcoma of the lung successfully treated with paclitaxel chemotherapy: A case report and brief literature review

Diffuse alveolar hemorrhage (DAH) is a life-threatening syndrome caused by various etiologies. DAH has rarely been reported to be associated with metastatic angiosarcoma. However, due to the rarity of complications, it may not be well-recognized by most clinicians. Herein, we report the case of a 70-year-old man with newly diagnosed metastatic cardiac angiosarcoma presenting with DAH. After an immediate bronchoalveolar lavage study and bronchoscopic biopsy, the patient was successfully treated with paclitaxel chemotherapy. Although most patients with this phenomenon have an extremely grave prognosis in previous literature, our experience showed that appropriate evaluation and treatment may be beneficial.

Clinical Characteristics and Risk Factors of Diffuse Alveolar Hemorrhage in Systemic Lupus Erythematosus: a Systematic Review and Meta-Analysis Based on Observational Studies

Diffuse alveolar hemorrhage (DAH) is a rare but potentially deadly manifestation of systemic lupus erythematosus (SLE). The aim of this study was to investigate the clinical characteristics and risk factors of DAH in SLE. A systematic review and meta-analysis of previous observational studies compared the clinical characteristics and risk factors between DAH-SLE and SLE patients without DAH. A total of 5 observational studies were included in this meta-analysis. Compared with the SLE patients without DAH, DAH-SLE patients had a significantly higher incidence of neuropsychiatric events (OR = 4.321, 95% CI (1.686-11.073), P = 0.002, I² = 49.2%), nephritis (OR = 3.146, 95% CI (1.663-5.955,), P = 0.000, I² = 0.0%), serositis (OR = 6.028, 95% CI (1.418-25.635), P = 0.015, I² = 80.3%), dyspnea (OR = 31.241,95% CI (0.202-4833.203), P = 0.181, I² = 94.6%), and a significantly lower level of C3 (SMD = - 1.358, 95% CI - 1.685, - 1.031), P = 0.000, I² = 98.0%), C4 (SMD = - 1.251, 95% CI (- 1.648, - 0.855), P = 0.000, I² = 87.7%), hemoglobin (SMD = - 2.074, 95% CI (- 2.433, - 1.715), P = 0.000, I² = 94.2%), and a higher SLEDAI-2K score (SMD = 1.284, 95% CI (0.959, 1.608), P = 0.000, I² = 98.2%). However, due to significant heterogeneity, some of these results should be interpreted cautiously. Nevertheless, when the above abnormal indicators are found, especially neuropsychiatric involvement and nephritis, besides the existed diagnostic criteria for DAH in SLE patients, a diagnosis for DAH should be considered and relevant treatment timely initiated. Further prospective multi-center SLE studies with a large cohort of patients and long-term follow-up are needed to clarify further or find out the specific clinical indexes for DAH in SLE patients.