Hemoptysis

[Guest]

About a year ago my father was prescribed a medication called Vasotec. He developed a severe cough from it. Once he started coughing up blood, the doctor immediately took him off the medication. Throughout the year my father developed bronchitis where he began coughing up blood again. Levaquin was prescribed to him and it subsided. However the blood kept coming back. Last week, he coughed up too much blood and we took him to the emergency room.
He's had numerous CT scans and chest x-rays but no diagnosis.

My fathers's doctor tried performing a broncoscopy but could not get passed his vocal chords. She then decided to put him under anesthesia and try the broncoscopy again. There was too much bleeding to determine where it was coming from. The next step is to try the broncoscopy again in a week after the bleeding subsides. She gave him an anitibiotic (Levaquin) to stop the bleeding.

My question is: do you think this doctor is approaching this in the right way? It seems that all this time has gone by and still no diagnosis?

Any information would be appreciated.

Thank you very much.

[Guest]

hemoptysis can be difficult to treat and to find the cause. the usual approach is a bronchoscopy and ct scan if it gets really significant. I think a repeat bronchoscopy when the bleeding is less is reasonable, however, if the bleeding worsens again more may be needed. In my practice, that is when I would have cardiothoracic surgeon see the patient and take the patient to the operating room for a "rigid" bronchoscopy under anesthesia. This may be what he already had.
[quote] About a year ago my father was prescribed a medication called Vasotec. He developed a severe cough from it... [/quote]

[Guest]

Thank you for your response. He is going to have a rigid broncoscopy soon. For some reson the antibiotics prevent my father from coughing up blood. Can you please explain why? Do the antibiotics give any clues on what his problem could be?
[quote] hemoptysis can be difficult to treat and to find the cause. the usual approach is a bronchoscopy and ct scan if it gets really significant... [/quote]

[Guest]

sometimes inflammation in the lungs can cause the bleeding, such as in bronchitis. Antibiotics can help decrease inflammation caused by infection. I am not sure how this may help your father's case but a rigid bronchoscopy is a good next step.
[quote] Thank you for your response. He is going to have a rigid broncoscopy soon... [/quote]

[Guest]

The thoracic surgeon took a biopsy of the inflammation. He said that the inflammation has gotten worse since he last had a broncoscopy 10 days ago. Some of the results came out negative for cancer. The rest of the results need to come back but he is leaning towards the possibility of an auto-immune disease such as lupus. I did some research on lupus and found that there are some drugs asscociated with giving you symptoms of lupus. One of those drugs is Labetalol. My father has taken Labetalol for his high blood pressure for about a year now. So its quite possible that this is causing him problems. Have you ever heard of particular drugs that are the cause of lupus?
[quote] sometimes inflammation in the lungs can cause the bleeding, such as in bronchitis. Antibiotics can help decrease inflammation caused by infection... [/quote]

[Guest]

there are drugs that cause a lupus like syndrome and it is possible that is contributing to a condition like this.
[quote] The thoracic surgeon took a biopsy of the inflammation. He said that the inflammation has gotten worse since he last had a broncoscopy 10 days ago... [/quote]