ABSTRACT
Diffuse alveolar haemorrhage (DAH) is the clinicopathologic syndrome of the accumulation of red blood cells in the alveolar spaces. This chapter focuses on those drugs that have the strongest evidence for causing pulmonary capillaritis. Diffuse alveolar damage is diagnosed by the histological presence of alveolar–septal and intra-alveolar oedema, capillary congestion and microthrombi with intra-alveolar hyaline membrane formation. Excess anticoagulation during warfarin or heparin therapy, or poisoning with superwarfarin rotenticides, may cause DAH in which the only clinical findings are dyspnoea, unexplained anaemia and evolving pulmonary infiltrates. Primary pulmonary hypertension is a rare disease, which is characterized by progressive elevation in pulmonary artery pressures and vascular resistance and is associated with a poor prognosis. In drug-induced coagulation disorders, treatment should be primarily aimed at restoration of normal bleeding times with vitamin K and fresh frozen plasma as well as transfusion with platelets if thrombocytopenia is thought to be a contributing factor.
