Correct!
5. All of the above
The patient has diffuse alveolar hemorrhage (DAH) which refers to hemorrhage originating in the pulmonary microvasculature, rather than from the bronchial circulation or parenchymal abnormalities (1). The microvascular hemorrhage results in the progressively bloodier returns. It is seen in a number of disorders including collagen vascular diseases with an associated vasculitis such as systemic lupus erythematosis, elevated pulmonary artery pressures such as mitral stenosis, bleeding disorders such as excess anticoagulation or drugs such as crack cocaine inhalation.
Treatment is based on the underlying cause. In cases of drugs and bleeding disorders it is supportive care while removing exposure to the offending agent or correcting the underlying bleeding disorder. In cases with elevated pulmonary artery pressure it is to lower the pressure.
In our patient, Coccidioidomycosis serology was negative; there was no history of a bleeding disorder or drug use; and there was no clinical evidence of elevated pulmonary artery pressures.
Which of the following have been used to treat diffuse alveolar hemorrhage associated with pulmonary vasculitis?