Categories of Albelda et al for Diffuse Pulmonary Hemorrhage (DPH)

Albelda et al reported a classification for diffuse pulmonary hemorrhage (DPH). The authors are from the Hospital of the University of Pennsylvania.

Patient selection: diffuse pulmonary hemorrhage

Parameters:

(1) renal disease

(2) immunologic factors

(3) nonimmunologic factors

Renal Disease	Immunologic Factors	Nonimmunologic Factors	Group
glomerulonephritis	anti-GBM	NA	1
renal disease	absent	suspected or present	2A
renal disease	suspected but testing negative	NA	2B
glomerulonephritis	immune complexes	variable	3
absent	immune complexes	NA	4
absent	anti-GBM	NA	5
absent	absent	idiopathic	6A
absent	absent	coagulopathy with bleeding	6B
absent	absent	acute lung injury	6C
absent	absent	miscellaneous	6D

where:

• anti-GBM = antibody to glomerular basement membrane

Group	Example
1	Goodpasture syndrome
2A	uremia, Legionaire's disease
2B	crescentic glomerulonephritis negative for anti-GBM and for immune complexes
3	SLE, Wegener's granulomatosis, cryoglobulinemia, Henoch-Schonlein purpura, mixed connective tissue diseaes, systemic vasculitis with immune complexes
4	SLE, Wegener's granulomatosis, systemic vasculitis with immune complexes
5	early Goodpasture's syndrome or variant Goodpasture's
6A	no secondary cause identified
6B	DIC, thrombocytopenia, anticoagulant-associated
6C	ARDS, toxic inhalation, oxygen toxicity
6D	blunt trauma, mitral stenosis, drug-induced, aspiration of blood

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