Abstract

RONDON-CARVAJAL, Julián; ALVAREZ-LOPEZ, Santiago  and  ESCUDERO-CORREA, María José. Diffuse alveolar hemorrhage in a patient with refractory primary immune thrombocytopenia: a case report. Medicas UIS [online]. 2024, vol.37, n.1, pp.121-131.  Epub Mar 30, 2024. ISSN 0121-0319.  https://doi.org/10.18273/revmed.v37n1-2024010.

Diffuse alveolar hemorrhage, a manifestation of several immune and non-immune diseases, is a rare complication of primary autoimmune thrombocytopenia. It is considered in patients with dyspnea, alveolar opacities in chest images and the presence of more than 20 % of hemosiderin-laden macrophages in bronchoalveolar lavage. We present the case of a woman with a known diagnosis of primary immune thrombocytopenia, referred from an outpatient clinic for platelet count less than 10 000 platelets/milliliter, who presented with rapid onset hypoxemia, ground-glass opacities and bronchoalveolar lavage with a high number of hemosiderin-laden macrophages, configuring a diagnosis of alveolar hemorrhage, which responded to combined cytostatic therapy in terms of sustained improvement in platelet count. The importance of identifying elements of clinical judgment that allow early diagnosis, as well as establishing transdisciplinary bridges leading to effective treatment in a potentially fatal scenario, is argued.

Keywords : Hemoptysis; Bronchoalveolar lavage; Blood-air barrier; Thrombocytopenia; Autoimmunity.

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