Idiopathic pulmonary hemosiderosis without hemoptysis in an adult: A rare presentation

Jackin Moses R,Kisku Kh,Madhusmita M,Manjiri P,Nishant Sinha

doi:10.5348/ijcri-2014-03-480-cr-11

Jackin Moses R, Kisku Kh + Show 3 more

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https://doi.org/10.5348/ijcri-2014-03-480-cr-11

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Journal: International Journal of Case Reports and Images	Publication Date: Jan 1, 2014
Citations: 11	License type: cc-by

Abstract

Introduction: Idiopathic pulmonary hemosiderosis (IPH) is defined as a clinical triad of hemoptysis, pulmonary infiltrates, and iron deficiency anemia. It is a diagnosis of exclusion when all other causes of diffuse alveolar hemorrhage have been ruled out. Epidemiologically, IPH is a rare disease, with an incidence of 0.24 per million children per year; overall, 80% of cases occur in children, most being diagnosed in the first decade of life. Case Report: We present a 38-year-old female who presented to our casualty with acute respiratory failure which resolved on high dose corticosteroids. Patient on evaluation was diagnosed to have diffuse alveolar hemorrhage with idiopathic pulmonary hemosiderosis. Patient is currently asymptomatic and is on regular follow-up in our hospital. Conclusion: Diffuse alveolar hemorrhage should be a differential diagnosis in a patient presenting with hemoptysis, breathlessness, anemia and radiological evidence of infiltrates. Awaiting detailed work-up, patients should be promptly started on high dose steroids. (This page in not part of the published article.) IJCRI – International Journal of Case Reports and Images, Vol. 5 No. 3, March 2014. ISSN – [0976-3198] IJCRI 2014;5(3):230–234. www.ijcasereportsandimages.com Moses et al. 230 CASE REPORT OPEN ACCESS Idiopathic pulmonary hemosiderosis without hemoptysis in an adult: A rare presentation Jackin Moses R, Nishant Sinha, Madhusmita M, Kisku KH, Manjiri P

Highlights

Idiopathic pulmonary hemosiderosis (IPH) is defined as a clinical triad of hemoptysis, pulmonary infiltrates, and iron deficiency anemia
IPH is a rare disease, with an incidence of 0.24 per million children per year; overall, 80% of cases occur in children, most being diagnosed in the first decade of life
Patient is currently asymptomatic and is on regular follow-up in our hospital.Conclusion: Diffuse alveolar hemorrhage should be a differential diagnosis in a patient presenting with hemoptysis, breathlessness, anemia and radiological evidence of infiltrates

Summary

Introduction

Idiopathic pulmonary hemosiderosis (IPH) is defined as clinical triad of hemoptysis, pulmonary infiltrates, and iron deficiency anemia [1, 2]. A 38-year-old female, presented to our emergency room with progressive breathlessness (MMRC grade 24) and dry cough for three months She had history of multiple blood transfusions elsewhere during the prior three months period. Subsequent investigations revealed corrected reticulocyte count 0.5%, microcytic hypochromic peripheral blood smear, low serum iron (36 μg/dL), low transferrin saturation (28%), normal Ferritin (140.2 ng/mL), normal total iron binding capacity (415 μg/ dL) and normal serum vitamin B12 and folic acid levels. Her stool was negative for occult blood or parasites. Her chest X-ray and CT thorax repeated after one month showed complete clearing of the shadows (Figure 5)

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CONCLUSION