Resumen

RIOS, Mateo et al. Non-inmune mediated diffuse alveolar hemorrage in children. Arch. Pediatr. Urug. [online]. 2019, vol.90, n.2, pp.83-89. ISSN 0004-0584.  https://doi.org/10.31134/ap.90.2.6.

Non-immune mediated alveolar hemorrhage is a rare pathology affecting both children and adults. Although the causes of this disease are known, their interaction in case of bleeding is not clearly understood.

The present paper discusses 4 clinical cases of non-immune mediated alveolar hemorrhage and a hypothesis is presented with the objective of explaining the interrelation of the factors that may affect the its development.

In order to comply with the gas exchange function, the alveolar-capillary membrane must not be too thick, since this might lead to stress failure and to eventual blood extravasation to the lung parenchyma. The basement membrane (type IV) collagen, plus the alveoli arrangement and the pulmonary interstitium, provide extraordinary resistance to such membrane. Whenever the alveolar-capillary membrane is weak, either due to immaturity or to pathological situations, there is a significant risk of rupture. Hemodynamic and coagulation alterations can be determining factors in the development of this pathology, since they affect the development of stress failure or perpetuate the passage of blood to the pulmonary interstitium.

Palabras clave : Hemorrhage; Pulmonary alveoli.

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