Objective To analyze the clinical manifestation of diffusive alveolar
hemorrhage in acute
leukemia induction
therapy.
Methods Clinical data of two diagnosed cases of diffusive alveolar
hemorrhage secondary to acute
leukemia were collected.Clinical data of eight cases of diffusive alveolar
hemorrhage secondary to acute
leukemia which were published were also collected by searching in
Medline database.The clinical manifestation,
diagnosis,strategy of
differential diagnosis and
treatment of diffusive alveolar
hemorrhage secondary to acute
leukemia were analyzed.Results Diffusive alveolar
hemorrhage was a rare but fatal complication of acute
leukemia.The common clinical manifestations included
hemoptysis,progressive
dyspnea and progressive decrease in concentration of
hemoglobin.The
analysis of
blood gas showed type Ⅰ
respiratory failure.The manifestations of
chest computed
tomography included diffusive ground
glass opacity and infiltration of parenchyma.The
bronchoalveolar lavage fluid was bloody.And
lung biopsy showed congestion of alveoli and capillaritis.The
detection for pathogens,
vasculitis related
antibodies,
brain natrium
peptide were negative.The
mortality of those cases was 40 % (4/10).
Corticosteroids therapy was effective.The
mortality of
patients received
corticosteroids therapy was 25 % (2/8).Conclusion Diffusive alveolar
hemorrhage is a rare but fatal complication of acute
leukemia.The
mortality is high.The key points of
therapy are
early diagnosis and
corticosteroids therapy.