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Minerva Respiratory Medicine 2021 December;60(4):124-30

DOI: 10.23736/S2784-8477.21.01952-5


language: English

Clinical features and long-term prognostic outcomes in patients with hemoptysis related to upper respiratory airways diseases: a prospective, Italian, multicenter study

Michele MONDONI 1 , Paolo CARLUCCI 1, Rocco RINALDO 1, Giuseppe CIPOLLA 2, Nicolò VANONI 2, Alessandro FOIS 3, Pietro PIRINA 3, Stefano GASPARINI 4, Martina BONIFAZI 4, Silvia MARANI 5, Andrea COMEL 6, Laura SADERI 7, Beatrice VIGO 1, Fausta ALFANO 1, Paolo SOLIDORO 8, 9, Stefano CENTANNI 1, Giovanni SOTGIU 7

1 Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy; 2 Unit of Pneumology, ASST Lodi, Lodi, Italy; 3 Unit of Lung Disease, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy; 4 Unit of Pulmonary Disease, Department of Internal Medicine, Department of Biomedical Sciences and Public Health, Azienda Ospedali Riuniti, Polytecchnic University of Marche, Ancona, Italy; 5 Unit of Internal Medicine, AUSL Modena, Carpi Hospital, Carpi, Modena, Italy; 6 Unit of Pneumology, P. Pederzoli Hospital, Peschiera del Garda, Verona, Italy; 7 Unit of Clinical Epidemiology and Medical Statistics, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; 8 Division of Respiratory Medicine, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, University of Turin, Turin, Italy; 9 Department of Medical Sciences, University of Turin, Turin, Italy

BACKGROUND: Hemoptysis related to upper airways diseases is a rare cause of respiratory bleeding. Aim of the study was to describe the clinical features and the long-term prognostic outcomes of patients with hemoptysis related to upper airways diseases. The diagnostic yield of the most frequently prescribed examinations was computed.
METHODS: Observational, prospective, multicenter, Italian study.
RESULTS: Twelve patients (mean, SD, age 55.2, 17.7, years) were recruited. Most of them had mild hemoptysis (7/12, 58.3%) with a duration >7 days (5/12, 41.7%). Cough and dyspnea were the most frequently associated symptoms (in 4/12, 33.3%, and 3/12 (25.0%) patients, respectively). Bronchoscopy and (ear, nose and throat) ENT evaluation showed the highest yield (80% and 91.6%, respectively). One death and five recurrence episodes were recorded during the follow-up. No differences in mortality and recurrence rates were detected between smokers and nonsmokers and between patients with and without antiplatelets and/or anticoagulants.
CONCLUSIONS: Hemoptysis related to the upper respiratory tract caused by infections and malignancies, is mild and shows an overall good prognosis and a low rate of recurrences, regardless of the smoking history and the antiplatelet/anticoagulant therapy. Bronchoscopy and ENT are crucial for the diagnosis.

KEY WORDS: Hemoptysis; Bronchoscopy; Larynx; Neoplasms

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