Diffuse Alveolar Hemorrhage Occurring Suddenly in a Diabetic Patient With Asthma Exacerbation

Abstract

Diffuse alveolar hemorrhage (DAH) is a rare but potentially life-threatening condition characterized by bleeding into the alveolar spaces of the lungs. DAH can occur due to a wide range of etiologies including autoimmune diseases, infections, drugs, and malignancies. The clinical presentation is variable and may include cough, dyspnea, fever, and hemoptysis. Diagnosis is often challenging due to the nonspecific symptoms and a lack of definitive diagnostic criteria. Treatment is primarily aimed at addressing the underlying cause and providing supportive care.

Keywords: anatomic and clinical pathology; autopsy pathologist; diffuse alveolar hemorrhage; goodpasture's syndrome; poor asthma outcomes; pulmonary-renal syndrome; teaching in emergency medicine.

Figure 1. Right lung, middle lobe showing a marked consolidation

Figure 2. Right lung, middle lobe: intra-alveolar hemorrhage (200x, H&E)

Figure 3. Right lung, middle lobe showing a perivascular lymphoplasmacytic infiltration (400x, H&E)

Figure 4. Right lung, middle lobe: microvascular thrombosis (400x, H&E)

Figure 5. Left myocardium showing area of fibrosis consistent with past myocardial infarction (4x, H&E)

Figure 6. Right kidney showing glomerulosclerosis, tubular atrophy, and chronic interstitial nephritis (200x, H&E)