Clinical features, paraclinical characteristics, and etiology of mediastinal bleeding diffusion in children at the Vietnam National Children’s Hospital from 2018 to 2023

Abstract

Background: In modern life, diffuse alveolar haemorrhage (DAH) is a serious and rare condition in children. Due to the subtle clinical manifestations and diverse causes of the disease, it is easy to be missed or diagnosed late. This study describes clinical and paraclinical characteristics, with the aim to find signs suggesting early diagnosis as well as determine the cause of DAH in children. Objects and methods: Case series. Results: From January 2018 to March 2023, there were 14 children diagnosed with DAH. The age of onset is 4.08 (1.58-5.41) years old, but most patients are diagnosed late with age at diagnosis being 5.25 (1.67-6.16) years old, male/female ratio is 1:1.8. The most common symptoms reported were anaemia (100%), hemoptysis (57.1%), shortness of breath (71.4%), and respiratory failure (85.7%). The common X-ray finding was diffuse infiltrates in both lungs (92.9%). On chest computed tomography scans, 92.9% of patients exhibited images of blurred opacity spreading, 57.1% showed interlobar pleural thickening, and 28.6% presented with images of lung consolidation. 3 patients (22%) had milk allergy, 2 patients (14%) had ANCA (Anti-neutrophil cytoplasmic antibody) vasculitis, and 9 patients (64%) had idiopathic pulmonary haemosiderosis (IPH).