Recurrence of Idiopathic Pulmonary Hemosiderosis Associated with Rising Plasma IgE Levels and Antibody Titers to Specific Inhalants during a 10-Year Follow-Up

Abstract

We report 10-year follow-up of a boy diagnosed with idiopathic pulmonary hemosiderosis (IPH). In early childhood, the primary etiology appeared viral, and frequent exacerbations occurred with respiratory infection. Progressive elevation of total IgE and graminaceous grass pollen–specific antibodies gradually become more evident. Furthermore, the flowering period of these plants had coincided with exacerbations in the previous couple of years. The most recent admission to our hospital followed relapse of IPH after an excursion to a nature park during the flowering period. Since the last hospitalization, relapse has not occurred for over a year during treatment with inhaled beclomethasone and leukotriene antagonist, with intravenous liposteroid initially administered on alternate days, tapering to every 6 days. Although these findings were observed from a single case, they suggest that exposure to plant allergens can trigger exacerbation of IPH. Pediatricians should be aware that relapse of IPH may be caused by inhalants and that the underlying mechanism of relapse may vary during the disease course. (Pediatr Asthma Allergy Immunol 2005; 18[3]:161–166.)