Hemoptysis requiring bronchial artery embolization in patients with nontuberculous mycobacterial lung disease

BMC Pulmonary Medicine

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[1] 0000 0001 2171 7754, grid.255649.9, Department of Radiology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea;0000 0001 2171 7754, grid.255649.9, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, 07985, Seoul, Republic of Korea;0000 0004 0470 5454, grid.15444.30, Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea;grid.412479.d, Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea;

关键词: Mycobacterium infections, nontuberculous;    Tuberculosis;    Hemoptysis;    Embolization, therapeutic;   

DOI  :  10.1186/s12890-019-0881-z

来源: publisher

【 摘 要 】

BackgroundAlthough infections caused by nontuberculous mycobacteria (NTM) are increasing in prevalence, there are few data about hemoptysis in patients with NTM lung disease. This study investigated the characteristics and prognosis of hemoptysis secondary to NTM infection.MethodsFollowing a retrospective review of cases managed between 2006 and 2016, 183 patients with NTM lung disease were enrolled and analyzed.ResultsAmong 183 patients with NTM lung disease, Mycobacterium intracellulare (n = 64, 35%) was the major cause of NTM infection, followed by M. avium (n = 59, 32.2%) and M. abscessus complex (n = 40, 21.9%). Hemoptysis developed in 78 patients (42.6%), among whom 33 (42.3%) required bronchial artery embolization (BAE). Between patients with and without hemoptysis, there were no significant differences with respect to sex, radiographic manifestations, distribution over 3 lobes on chest computed tomography, history of pulmonary tuberculosis, antiplatelet or anticoagulation therapy, and species of NTM. However, mean age at diagnosis was significantly lower in the hemoptysis group in univariate and multivariate analyses (65.7 ± 12.8 vs. 59.7 ± 11.8, P = 0.002, odds ratio: 0.969, 95% confidence interval: 0.944–0.996). Among patients with hemoptysis, those requiring medical therapy and those requiring BAE were not significantly different in terms of demographic characteristics, radiographic manifestations, and distribution over 3 lobes. All patients who received BAE showed immediate clinical improvement, no procedure-related complications, and none of them died during the period under review.ConclusionsNTM lung disease patients commonly experienced hemoptysis without specific risk factors except for relatively young age. Although some patients with hemoptysis needed BAE, the success rate of BAE was high, and there were no serious complications associated with BAE.

【 授权许可】

CC BY