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Yang J, Park JE, Han S, Han CW, Kim C, Hyun CL, Kim J, Jo J. Diffuse alveolar hemorrhage from metastatic cardiac angiosarcoma of the lung successfully treated with paclitaxel chemotherapy: A case report and brief literature review. Respir Med Case Rep 2021; 34:101538. [PMID: 38234680 PMCID: PMC10792683 DOI: 10.1016/j.rmcr.2021.101538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Jieun Yang
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea
| | - Ji Eun Park
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea
| | - Sanghoon Han
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea
| | - Chi Wha Han
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea
| | - Changhwan Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea
| | - Chang Lim Hyun
- Department of Pathology, Jeju National University Hospital, Jeju, Republic of Korea
| | - JeongJae Kim
- Department of Radiology, Jeju National University Hospital, Seoul, Republic of Korea
| | - Jaemin Jo
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea
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Xu T, Zhang G, Lin H, Xie Y, Feng Y, Zhang X, Dong G. Clinical Characteristics and Risk Factors of Diffuse Alveolar Hemorrhage in Systemic Lupus Erythematosus: a Systematic Review and Meta-Analysis Based on Observational Studies. Clin Rev Allergy Immunol 2021; 59:295-303. [PMID: 31440948 DOI: 10.1007/s12016-019-08763-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Ting Xu
- Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Second Road, Guangzhou, 510080, Guangdong, China
| | - Guangfeng Zhang
- Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Second Road, Guangzhou, 510080, Guangdong, China
| | - Haobo Lin
- Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Second Road, Guangzhou, 510080, Guangdong, China
| | - Yuesheng Xie
- Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Second Road, Guangzhou, 510080, Guangdong, China
| | - Yuan Feng
- Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Second Road, Guangzhou, 510080, Guangdong, China
| | - Xiao Zhang
- Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Second Road, Guangzhou, 510080, Guangdong, China.
| | - Guangfu Dong
- Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Second Road, Guangzhou, 510080, Guangdong, China.
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