Diffuse alveolar haemorrhage: a rare complication of clopidogrel use. Issue 8 (9th August 2021)

• Record Type: Journal Article
• Authors: Soriano, Rachelle; Al-Rawaf, Saud; Diab, Khalil
• Is Part Of: BMJ case reports. Volume 14:Issue 8(2021)
• Publication Date: 2021-08-09
• Subjects: drugs: respiratory system -- interstitial lung disease -- vasculitis -- adult intensive care; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2021-244314
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Diffuse alveolar haemorrhage (DAH) has been reported as a rare complication of clopidogrel use and is usually a diagnosis of exclusion. We describe the case of an 88-year-old Native American woman who presented with acute hypoxic respiratory failure with CT scan of the chest showing diffuse bilateral ground-glass opacities. She had been on clopidogrel for 6 months for a carotid artery stent. Bronchoscopy with bronchoalveolar lavage and transbronchial biopsies revealed DAH. Infectious and autoimmune work-up were all negative. Clopidogrel was stopped and high-dose steroids were started. Her symptoms gradually improved until she was discharged from the hospital. The differential DAH is broad. Anticoagulant-induced DAH should be part of the differential diagnosis, and is usually a diagnosis of exclusion.