Cor triatriatum sinister: a rare underlying cause of pulmonary hemosiderosis.

Shuhan Peng,Pingbo Liu,Jinwen Luo,Peng Huang,Yunbin Xiao,Renwei Chen,Xicheng Deng

doi:10.1186/s40064-016-1752-1

Shuhan Peng, Pingbo Liu + Show 5 more

Open Access

https://doi.org/10.1186/s40064-016-1752-1

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Journal: SpringerPlus	Publication Date: Feb 24, 2016
Citations: 10	License type: CC BY 4.0

Affiliation: University of South China, Hunan Children's Hospital

Abstract

Pulmonary hemosiderosis is a disorder with unknown cause and characterized by hemosiderin appreciation in alveolar interstitium from decomposed hemoglobin following alveolar capillary bleeding, which finally leads to pulmonary fibrosis. It can be divided into primary and secondary types in terms of its etiology. While primary types are related to autoimmunity, secondary types can be associated with cardiovascular and pulmonary causes such as mitral stenosis leading to pulmonary congestion. We report a case of cor triatriatum sinister in a child who presented with hemoptysis as a main clinical manifestation and had been previously diagnosed with idiopathic pulmonary hemosiderosis. Based on clinical signs and imaging examinations, we considered the hemoptysis was most likely due to cor triatriatum. The child underwent corrective surgery with uneventful recovery. The hemoptysis has not recurred any more after operation. Cardiovascular disease including cor triatriatum should be considered with regards to the etiology of pulmonary hemosiderosis.

Highlights

Pulmonary hemosiderosis is a disorder characterized by precipitation of hemosiderin from decomposed hemoglobin following alveolar capillary bleeding in alveolar interstitium (Ioachimescu et al 2004)
The case we report is a child with cor triatriatum in whom hemoptysis presented as a main clinical manifestation and idiopathic pulmonary hemosiderosis (IPH) was initially diagnosed
Cor triatriatum sinister is characterized by an abnormal separation of the left atrium into a pulmonary venous chamber and a true chamber (Richardson et al 1981)

Summary

Background

Pulmonary hemosiderosis is a disorder characterized by precipitation of hemosiderin from decomposed hemoglobin following alveolar capillary bleeding in alveolar interstitium (Ioachimescu et al 2004) It can be divided into primary and secondary types. Physical examination revealed coarse lung breath sounds and a II/VI rough systolic murmur on the left sternal border at 2–3 intercostal space She had 3 episodes of hemoptysis in total over the last 6 months and two visits to respiratory medicine clinic 2 and 3 months ago, respectively. She had been on methylprednisolone for four consecutive months before this admission She was anemic 4 months ago before initiation of corticosteroids (Hbs 87–94 g/L), During present hospitalization, the preoperative Hb was 118 g/L, oxygen saturation 96 %.

Discussion

Conclusions