Alveolar hemorrhagic syndrome in sarcoidosis

BACKGROUND: Alveolar hemorrhage is uncommon in sarcoidosis, even in the presence of severe alveolitis. PATIENT: A heavy smoker with bihilar adenopathy presented with severe alveolar hemorrhage in the absence of radiological signs of pulmonary involvement. Sarcoidosis was confirmed histologically by transbronchial and mediastinal lymph node biopsies. The bleeding stopped before the installation of anti-inflammatory medication and did not reoccur within 9 months of follow up, but BAL analysis demonstrated the persistence of alveolar siderophages. CONCLUSIONS: Sarcoidosis should be considered as a rare cause of diffuse alveolar hemorrhage.