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

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.