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PEDIATRICS Vol. 110 No. 3 September 2002, pp. 627-637

EXPERIENCE AND REASON

Clinical Profile of 30 Infants With Acute Pulmonary Hemorrhage in Cleveland

Between 1993 and 2000, 30 infants were hospitalized with acute pulmonary hemorrhage at Rainbow Babies and Children’s Hospital in Cleveland. Most infants presented with severe pulmonary symptoms requiring intensive support, but a few infants had less severe hemorrhage. Three quarters of the patients required ventilator support and blood transfusions. Eleven patients had transitory hemoglobinuria. Five patients died, but infants who survived did well. There are currently no specific treatment modalities, although we have advised moving to a different home and avoiding environmental tobacco smoke. Subsequently, rebleeding from the lower respiratory tract has decreased from 5 of 7 infants to 1 in 21. On the basis of decreased subsequent fatal hemorrhage, high dose glucocorticoids seem to be of some value. Several patients revealed continued low-grade alveolar hemorrhage for months after their initial bleed, even after removal from their original home environments.

Dorr G. Dearborn, PhD, MD, Paul G. Smith, DO

Pediatric Pulmonary Division
Department of Pediatrics
Rainbow Babies and Children’s Hospital
Case Western Reserve University
Cleveland, Ohio

Beverly B. Dahms, MD

Department of Pathology
University Hospitals of Cleveland
Case Western Reserve University
Cleveland, Ohio

Terrence M. Allan, MPH

Division of Community Health
Cuyahoga County Board of Health
Cleveland, Ohio

W.G. Sorenson, PhD

Division of Respiratory Disease Studies
National Institute for Occupational Safety and Health
Morgantown, West Virginia

Eduardo Montana, MD

Georgia Pediatric Cardiology
Atlanta, Georgia

Ruth A. Etzel, MD, PhD

George Washington University School of Public Health and Health Services
Washington, DC

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Key Words: pulmonary • hemorrhage • infant • home • environment

Abbreviations: BAL, bronchoalveolar lavage • ETS, environmental tobacco smoke

Received for publication Mar 26, 2001; Accepted Feb 12, 2002.


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