Spontaneous Diffuse Alveolar Hemorrhage in Severe Alcoholic Hepatitis-Case Report

Abstract

Diffuse alveolar haemorrhage is a clinical catastrophe that presents variably. The commonest etiologies include those of autoimmune and connective tissue diseases, especially granulomatosis with angitis and systemic lupus erythematosus. Infections and secondary disseminated intravascular coagulopathy has also been described to cause this condition. Spontaneous diffuse alveolar haemorrhage is a rare entity that occurs in the course of liver diseases.
Previously, light has been shed on occurrence of alveolar haemorrhage in the wake of hepatitis C virus infection and attendant immunological vasculitis phenomenon. Here we report the first case of diffuse alveolar haemorrhage in a patient of severe alcoholic hepatitis, in whom overt coagulopathy features were indiscernible. This further proves the fact that global and holistic approach hemostasis evaluation in diagnosing coagulation disorders of liver diseases could be the way forward, rather than conventional laboratory evaluation.