Diffuse alveolar hemorrhage secondary to sarcoidosis

Clin Rheumatol. 2023 Jun;42(6):1701-1704. doi: 10.1007/s10067-023-06556-1. Epub 2023 Feb 27.

Abstract

Diffuse alveolar hemorrhage (DAH) is a pulmonary condition that can be caused by autoimmune disorders such as lupus, small vessel vasculitis, and antiphospholipid syndrome. Sarcoidosis as a cause of DAH has been reported; however, the literature remains limited. We performed a chart review for patients with a diagnosis of both sarcoidosis and DAH. Seven patients met inclusion criteria. Mean (range) patient age was 54 years (39-72), and 3 patients had a history of tobacco use. Diagnosis of DAH and sarcoidosis were concurrent for 3 patients. Corticosteroids were used for treatment of DAH in all patients; 2 (including 1 with refractory DAH) were successfully treated with rituximab. We believe sarcoidosis-associated DAH is more common than previously reported. It is essential to consider sarcoidosis in the differential diagnosis of immune-mediated DAH. Key Points • Sarcoidosis can cause diffuse alveolar hemorrhage (DAH); more extensive studies are needed to estimate this condition's prevalence. • BMI of 25 or higher appears to be a risk factor for the development of sarcoidosis-associated DAH.

Keywords: Epidemiology; Lung disease; Observational studies; Unclassified autoimmune disorders.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Antiphospholipid Syndrome* / complications
  • Hemorrhage / diagnosis
  • Hemorrhage / etiology
  • Humans
  • Lung Diseases* / complications
  • Middle Aged
  • Pulmonary Alveoli
  • Sarcoidosis* / complications

Substances

  • Adrenal Cortex Hormones