Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (2)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Vincent, B.
Right arrow Articles by Cadranel, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Vincent, B.
Right arrow Articles by Cadranel, J.
(Chest. 2001;120:1078-1084.)
© 2001 American College of Chest Physicians

AIDS-Related Alveolar Hemorrhage*

A Prospective Study of 273 BAL Procedures

Benoît Vincent, MD; Antoine Flahault, MD; Martine Antoine, MD; Marie Wislez, MD; Antoine Parrot, MD; Charles Mayaud, MD and Jacques Cadranel, MD, PhD

* From the Service de Pneumologie et de Réanimation Respiratoire (Drs. Vincent, Wislez, Parrot, Mayaud, and Cadranel), Unité de Biostatistique INSERM U444 (Dr. Flahault), et Service d’Anatomie-Pathologique (Dr. Antoine), Hôpital Tenon, Paris, France.

Correspondence to: Jacques Cadranel, MD, PhD, Service de Pneumologie et de Réanimation Respiratoire, Hôpital Tenon AP-HP, 4 rue de la Chine, 75020 Paris, France; e-mail: jacques.cadranel{at}tnn.ap-hop-paris.fr

Study objectives: To evaluate the frequency and diagnostic significance of alveolar hemorrhage (AH) in HIV-infected patients.

Design: A 3-year prospective cohort study.

Setting: A university hospital in Paris, France.

Patients: Two hundred forty-three HIV-infected patients undergoing 273 BAL procedures during the study period.

Methods: AH was assessed by using the Golde score. Data on the patients treated and observed in our institution were collected, as well as on their survival rate 12 months after undergoing BAL. Risk factors for AH were sought by comparing patients with AH (cases) and those without AH (control subjects).

Results: AH frequently occurred but usually was subclinical and cytologically mild. AH did not alter the 12-month survival rate. AH always was associated with at least one specific AIDS-related pulmonary disorder, and the following four independent risk factors were identified in a stepwise forward logistic regression model: pulmonary Kaposi’s sarcoma (KS; odds ratio [OR], 5.3; 95% confidence interval [CI], 1.8 to 16.7; p = 0.003), cytomegalovirus (CMV) pneumonia (OR, 9.8; 95% CI, 1 to 100; p = 0.05), hydrostatic pulmonary edema (OR, 16.4; 95% CI, 1.8 to 142; p = 0.01), and platelet count < 60,000 cells/µL (OR, 5.6; 95% CI, 1.5 to 20; p = 0.009).

Conclusions: AH is frequently diagnosed during BAL in HIV-infected patients. Its presence may point to an underlying cause, such as pulmonary KS, CMV pneumonia, or hydrostatic pulmonary edema, or to triggering factors such as thrombocytopenia.

Key Words: AIDS • alveolar hemorrhage • cytomegalovirus • Kaposi’s sarcoma • pulmonary edema • thrombocytopenia






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American College of Chest Physicians.