Page 271 - The Vasculitides, Volume 1: General Considerations and Systemic Vasculitis

Systemic Vasculitis and the Lung 245

Table 1. Causes of Alveolar Hemorrhage

Disease or disease group Comments

Lung parenchymal disease / inflammation Mainly GPA and MPA (rarely
EGPA)
Small vessel vasculitis ANCA associated vasculitis
Rarely IgA vasculitis
Anti-GBM disease (exceptionally, cryoglobulinemic
Immune-complex mediated vasculitis)
vasculitides
Through lung disease and/or
Other systemic diseases Isolated (idiopathic) lung associated vasculitis
capillaritis Through lung disease and/or
Systemic lupus erythematosus associated vasculitis and/or veno-
Antiphospholipid syndrome occlusive disease
Rheumatoid arthritis
Most can cause interstitial lung
Systemic scleroderma infiltrate rather than diffuse
alveolar hemorrhage
Polymyositis / dermatomyositis

Sarcoidosis

Drug-related lung toxicity Propylthiouracil,

diphenylhydantoin, amiodarone,

mitomycin, D-penicillamine,

methotrexate, gold, haloperidol,

nitrofurantoin all-trans-retinoic

acid, bleomycin

Toxic and irritant Trimellitic anhydride,

inhalation isocyanates, crack cocaine,

pesticides, detergents

Miscellaneous Lung-graft rejection

Infections: Human immunodeficiency virus

infection, infective endocarditis,

cytomegalovirus infection, herpes

simplex virus infection,

hantavirus infection, invasive

aspergillosis, Legionellosis,

Mycoplasmosis, Leptospirosis,

other bacterial pneumoniae

Not primarily due to lung parenchymal inflammation

Lung vessel and/or Multiple causes: traumas,

aneurysm rupture vascular malformation or

fibrodysplasia, vasculitis-related

aneurysms (Takayasu arteritis,
Behcet?s syndrome), lung

abscess/cavity or bronchial

lesions eroding nearly vessels,

etc.

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