Cannabis Smoking Induced Diffuse Alveolar Hemorrhage in a Young Adult

Abstract

Background: Diffuse alveolar hemorrhage (DAH) is a rare but potentially life-threatening pulmonary syndrome characterized by bleeding into the alveolar spaces, resulting in acute respiratory compromise. It commonly presents with hemoptysis, hypoxemia, diffuse pulmonary infiltrates, and rapidly progressive respiratory failure. Although various etiologies have been described, cannabis-associated DAH remains an uncommon clinical entity.

Case Description: A 25-year-old man presented with fever, cough, mild hemoptysis, and altered sensorium. On arrival at the emergency department, he was severely breathless, hypoxic, and required endotracheal intubation for airway protection. He had no known comorbidities, was not receiving anticoagulant therapy, and had a history of cannabis smoking. High-resolution computed tomography (HRCT) of the chest demonstrated diffuse ground-glass opacities with a crazy-paving pattern, suggestive of diffuse alveolar hemorrhage. The patient was managed with corticosteroids, lung-protective mechanical ventilation, and supportive care. Despite aggressive treatment, his condition deteriorated, and he ultimately succumbed to the illness.

Conclusion: This case highlights cannabis smoking as a rare but important potential cause of diffuse alveolar hemorrhage in young adults. Clinicians should consider cannabis exposure in the differential diagnosis of unexplained DAH, particularly in otherwise healthy individuals presenting with acute respiratory failure.