RT Journal Article SR Electronic T1 When water is thicker than blood: recognising a systemic cause of haemoptysis JF Archives of disease in childhood - Education & practice edition JO Arch Dis Child Educ Pract Ed FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP 210 OP 219 DO 10.1136/archdischild-2015-308957 VO 102 IS 4 A1 Eileen Wedge A1 Ed Abrahamson A1 Gareth Tudor-Williams A1 Simon Nadel A1 Jane Deal YR 2017 UL http://ep.bmj.com/content/102/4/210.abstract AB The case of an 11-year-old child presenting with acute haemoptysis and breathlessness is described. The girl was Malaysian and had recently arrived in the UK. She subsequently deteriorated, developing respiratory failure. The course of the illness is described, with reference to the diagnostic process at each stage. The case demonstrates the importance of having a broad investigatory approach in acute haemoptysis.