Pulmonary embolism and diffuse alveolar bleeding: combination options and therapy features

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Abstract

The analysis of the mechanisms of the formation of a rare clinical combination of pulmonary embolism (PE) and diffuse alveolar hemorrhage (DAH), which are complications of systemic vasculitis associated with antibodies to the cytoplasm of neutrophils (primarily granulomatosis with polyangiitis), systemic lupus erythematosus and secondary antiphlogistic syndrome – primary antiphospholipid syndrome and Goodpasture’s syndrome. Taking into account the chronological sequence of the occurrence of PE and DAH, 3 variants of the onset of these potentially fatal additions to the underlying disease were considered: the anticipatory DAH development of PE, delayed from DAH PE and joint (within 24 hours) formation of PE and DAH. A review of single descriptions of such a combination of complications of granulomatosis with polyangiitis is carried out, criteria are indicated, a working classification of severity is given and, taking this into account, a modern program of therapy for DAH as an independent event and in combination with PE.

About the authors

Andrey Yu. Tret’yakov

Belgorod National Research University

Author for correspondence.
Email: opensource2007@yandex.ru
ORCID iD: 0000-0001-8489-3851

д.м.н, проф., проф. Медицинского института ФГАОУ ВПО БГНИУ

Russian Federation, Belgorod

Stefka G. Radenska-Lopovok

Sechenov First Moscow State Medical University (Sechenov University); Russian Medical Academy of Continuous Professional Education

Email: opensource2007@yandex.ru
ORCID iD: 0000-0002-4669-260X

д.м.н, проф., проф. каф. патологической анатомии им. акад. А.И. Струкова ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет), проф. каф. патологической анатомии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Pavel I. Novikov

Sechenov First Moscow State Medical University (Sechenov University)

Email: opensource2007@yandex.ru
ORCID iD: 0000-0003-0148-5655

к.м.н., зав. ревматологическим отд-нием №1 клиники им. Е.М. Тареева УКБ №3 ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет)

Russian Federation, Moscow

Viktoriia A. Tret’yakova

People’s Friendship University of Russia

Email: opensource2007@yandex.ru
ORCID iD: 0000-0002-8990-3470

аспирант каф. внутренних болезней с курсом кардиологии и функциональной диагностики ФГАОУ ВО РУДН

Russian Federation, Moscow

Svetlana P. Zakharchenko

Belgorod National Research University

Email: openbox.2013@yandex.ru

к.м.н, ст. науч. сотр. Медицинского института ФГАОУ ВПО БГНИУ

Russian Federation, Belgorod

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