MPhil in pulmonary haemorrhage in children in Cape Town

Masu, Adelaide Ngina

MPhil in pulmonary haemorrhage in children in Cape Town

Thesis / Dissertation

2025

Publisher

University of Cape Town

Department

Department of Paediatrics and Child Health

Faculty

Faculty of Health Sciences

Abstract

Introduction: Diffuse alveolar haemorrhage (DAH) is a rare condition in childhood which carries high morbidity and mortality. Outcomes are improved by initiating appropriate investigations to ensure early diagnosis and institute correct and timely management. Objectives: To understand the clinicopathological features of DAH and its management on the outcomes of children with this diagnosis. Methods: A descriptive study was conducted on children attending a tertiary centre pulmonology clinic from the period 2000-2022. A review of the clinical data, investigations and lung biopsy results was done and outcomes were reported. Results: Sixteen children were included in the study. The median age at presentation was 1.79 years (IQR 0.48-3.15). At presentation, the median haemoglobulin (Hb)was 5.4 (IQR 3.6-85). Five out of16(31%) had haemoptysis. Seven children showed a pulmonary IgA vasculitis on biopsy. Of the most recent spirometry 5/14 (38.46) had a restrictive pattern. At diagnosis 6/16 (37%) received intravenous methyl-prednisone and 10/16(63%) received oral prednisone as treatment. The children who received more than one immunosuppressant agent as management were 14/16 (87%). Ten out of 16 children are in remission. Conclusion: Early diagnosis of DAH and multidrug management seems to improve outcomes. The finding of isolated IgA vasculitis on lung biopsy associated with DAH has not been well described.

Keywords

Diffuse alveolar haemorrhage

Cape Town

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