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Cryptogenic Hemoptysis: Clinical Features, Bronchoscopic Findings, and Natural History in 67 Patients

MARK ADELMAN, M.D.; EDWARD F. HAPONIK, M.D.; EUGENE R. BLEECKER, M.D.; and E. JAMES BRITT, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Mark Adelman, M.D.; Division of Pulmonary Medicine, Francis Scott Key Medical Center, 4940 Eastern Avenue; Baltimore, MD 21224.


Baltimore, Maryland


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;102(6):829-834. doi:10.7326/0003-4819-102-6-829
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We reviewed the clinical outcome of 67 patients with hemoptysis and a normal or nonlocalizing chest roentgenogram and nondiagnostic fiberoptic bronchoscopic examination. During a 38 ± 22 (SD) month period after bronchoscopy, 57 (85%) patients remained well without evidence of active tuberculosis or overlooked bronchogenic carcinoma, and 9 patients died of nonpulmonary conditions. One patient developed bronchogenic carcinoma 20 months after bronchoscopy and resolution of symptoms. Hemoptysis had resolved completely before hospital discharge in 38 (57%) patients, within 6 months in 60 (90%), and recurred in only 3. Five patients (7.5%) had intermittent episodes of bleeding for more than 1 year. Fiberoptic bronchoscopy effectively excludes specific underlying causes of hemoptysis in the setting of a normal chest roentgenogram. The prognosis for patients with cryptogenic hemoptysis is generally good, usually with resolution of bleeding within 6 months of evaluation.

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hemoptysis

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