Alveolar hemorrhage after inhalation of cocaine.

Frequency of recreational abuse of cocaine is increasing. We report the cas e of a patient who developed an acute anemia associated with an alveolar he morrhage after repeated inhalation of cocaine. He presented with daily hemo ptysis and dyspnea. Chest-X ray and CT scan showed bilateral micronodular o pacities. The fibroscopic alveolar lavage fluid showed fresh blood. DLCO/VA was 117% predicted. With oxygen therapy and no blood transfusion the evolu tion was positive within 48 hours, without relapse. The occurrence of hemop tysis in subjects who inhale cocaine must lead to suspect cocaine induced-p ulmonary hemorrhage.