Pulmonary Hemosiderosis in Association with Celiac Disease

A 15-year-old male had a history of increasing dyspnea on exertion, cough, sputum production, fever, weakness, hemoptysis, and diarrhea. Chest radiography demonstrated bilateral alveolar consolidation. Bronchoalveolar lavage fluid analysis revealed extensive hemosiderin-laden alveolar macrophages. On the basis of iron deficiency anemia, diarrhea, raised antigliadin and antiendomysial antibodies, widespread villous atrophy, and crypt hyperplasia on intestinal biopsy, celiac disease was diagnosed. After treatment with a gluten-free diet, all his clinical symptoms and radiographic findings improved within two weeks.     

支气管扩张症伴咯血的原因及治疗进展研究

<正>支气管扩张症是指支气管管壁部分或全部不可逆性扩张,直径明显增大^[1],通常与慢性支气管炎、阻塞性肺疾病等慢性肺疾病有关,具有病程长、反复发作的特点,且发病率随着年龄的增长而增加^[2]。扩张的气道形成了易于积聚痰液和细菌的环境,易引发反复气道感染和咳嗽、咳痰,尤其在清晨或夜间加重,严重的支气管扩张症可能导致支气管壁破裂,形成支气管瘘,进而导致咯血。据统计,支气管扩张症患者中有26.0%～51.2%伴有咯血症状,咯血会导致气道阻塞、呼吸困难、气促等症状加重,持续的大量咯血会导致贫血,影响机体的氧合功能^[3]。支气管扩张症相关咯血的治疗方法取决于临床严重程度,支气管扩张症急性加重引起的轻度咯血可采取对症治疗,     

同轴微导管超选择性支气管动脉栓塞治疗大咯血

本文报道同轴徽导管超选择性支气管动脉插管治疗8例内科治疗无效的大咯血病人。8例均达到立即止血的目的,一例首次选择性支气管动脉栓塞3天后复发出血,行超选择栓塞后未再次出血。随访2～9个月,一例栓塞两月后原发病恶化并复发出血拒治死亡,其余病人无复发出血,无严重并发症发生。结果表明超选择性支气管动脉栓塞止血操作简单,止血迅速,效果确切,并发症少,是一值得推广的技术。     

Ⅲ型肺结核病人气促、咯血症状与肺功能关系

目的：本文总结１０１例有咯血、气促症状的Ⅲ型肺结核病人常规肺功能改变。方法：气促按广州呼吸疾病研究所方法评级,其中２１．７８％为气促１级,１９．８０％为气促２级及以上。４５．５４％病人有咯血症状。结果：常规肺功能表明气促２级及以上病人ＰＦＶＣ（用力肺活量占预计值％）、PＦＥＶ_１（１秒量占预计值％）、ＰＭＭＦ（最大中期流速占预计值％）、ＦＥＶ_１％Ｇ（ＦＥＶ_１／ＦＶＣ）、ＰＰＥＦ（峰流速占预计值％）均显著低于气促０级或１级病人,且与年龄较大,病程较长有关（Ｐ＜０．０５或０．０１）。有咯血病人的ＲＭＭＦ、ＰＦＥＶ_１显著低于无症状者（Ｐ＜０．０５）。结论Ⅲ型肺结核病人的气促症状一定程度上反映患者肺功能丧失程度。有咯血症状的病人较无症状者具有更严重的阻塞性通气功能不良。     

超选择性支气管动脉栓塞治疗肺结核大咯血的价值

目的 探讨肺结构大咯血行超选择性支气管动脉栓塞（ＳＢＡＥ）治疗的价值。方法 对４１例肺结构大咯血患者行ＳＢＡＥ,随访４￣５２个月。对复发大咯血患者再次行ＳＢＡＥ治疗。结果 ４１例患者即时止血３５例,即时止血率８５．３％。一次性栓塞治毹６例,治愈率６３．４％。复发１５例,复发率３６．６％,其中日咯血量５００ｍｌ以上患者复发充高于日咯血量５００ｍｌ以下者（Ｐ〈０．０５）;合并有壁空洞和（或）广泛纤维化     

Bronchial artery embolization for hemoptysis: A systematic review and meta-analysis

ObjectiveTo assess the safety and efficacy of bronchial artery embolization (BAE) for hemoptysis.Methods and materialsDatabases with articles published in English, including Pubmed, Embase, Web of science and Chochrane library, were comprehensively searched to get accurate, up-to-date and sufficient literature about BAE for hemoptysis until March 2020. The technical success rates, immediate control rates, recurrence rates, mortality rates, and total complication rates (minor and major complication rates) extracted from the articles were pooled to estimate and assess the efficacy and safety of BAE using random-effect and fixed-effect models.Results21 articles published between 2008 and 2019, which include a total of 2511 patients, were studied to evaluate the safety and efficacy of BAE. The technical success and immediate control rates are 99.9% (95%CI: 99%–100%) and 99.5% (95%CI: 97.8%–99.2%), respectively. This study showed hemoptysis recurrence in 23.7% (95%CI: 18.5%–28.9%) with a mortality rate of 2% (95%CI: 0–3%). Additionally, the assessment of complications revealed a total complication rate of 13.4% (95% CI: 7.6–19.2%), in which 0.2% (95% CI: 0.2–0.4%) were major complications and 10% (95% CI: 4.7–9.6%) were minor complications.ConclusionBAE is an effective, safe, and feasible procedure with a low complication rate for hemoptysis patients. However, recurrence of hemoptysis is still at high risk after BAE due to different underlying diseases.     

Massive hemoptysis two months after an otherwise mild SARS-CoV-2 disease (COVID-19) treated with bronchial artery embolization - A case report

An otherwise healthy young man presented with massive hemoptysis 2 month following a mild coronavirus disease 2019 (COVID-19) and with no other identifiable cause of illness. The patient was successfully treated with bronchial artery embolization. We are strongly convinced that hemoptysis in this case was COVID-related. This unusual case of delayed COVID-related hemoptysis reveals new aspects in the understanding of mid-term and presumable auto-immune triggered effects in patients with initially only mild symptoms of the disease.     

Endovascular management of massive hemoptysis due to covid-19 related pulmonary artery pseudoaneurysm: A rare entity

Pulmonary artery pseudoaneurysms are rare causes of massive hemoptysis, even less common in setting of COVID-19 pneumonia. We describe and discuss an index case of cavitating COVID-19 pneumonia complicated by a pulmonary artery pseudoaneurysm without concomitant pulmonary thromboembolism. The patient presented with severe hemoptysis and was managed by endovascular coil embolization. Good technical and clinical success was achieved with complete resolution of hemoptysis.