Hemoptysis in young adults

Hemoptysis is a frequent medical complaint, which may require bronchoscopy for diagnosis and management. It is unclear which patients benefit most from bronchoscopy as an early component of their evaluation. Young adults who present with hemoptysis are assumed to be at lower risk for serious medical conditions when compared with older individuals, and there is little published research examining this patient group. We performed a retrospective review of all patients undergoing bronchoscopy for hemoptysis over the past 6 years at our institution to characterize the clinical presentation and diagnostic evaluation of young adults, including the diagnostic utility of bronchoscopy. Of the 18 patients who met our inclusion criteria, bronchoscopy in the setting of nonmassive hemoptysis with a normal chest radiograph and computed tomography scan of the chest did not identify any unsuspected endobronchial abnormalities. Patients who meet these criteria should be considered for close clinical follow-up without initial invasive bronchoscopic evaluation.