Abstract
Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of alveolar hemorrhage in children but should be considered in children with anemia of unknown origin who develop respiratory complications. It is commonly characterized by the triad of recurrent hemoptysis, diffuse parenchymal infiltrates, and iron-deficiency anemia. Pathogenesis is unclear and diagnosis may be difficult along with a variable clinical course. A 6-year-old boy was admitted to the hospital with a severe iron-deficiency anemia, but he later developed severe acute respiratory failure and hemoptysis requiring intubation and mechanical ventilation. The suspicion of IPH led to the use of immunosuppressive therapy with high dose of corticosteroids with rapid improvement in clinical condition and discharge from hospital.
Highlights
Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of alveolar hemorrhage in children [1, 2]
The aim of this paper is to present the diagnostic challenge and intensive care unit management of a 6-year-old boy with a severe respiratory failure due to IPH initially presenting as an iron-deficiency anemia
While there is no definitive etiology of IPH, an underlying immune process is likely, given its typical responsiveness to immunosuppressive therapy [10, 11]
Summary
Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of alveolar hemorrhage in children [1, 2]. It is commonly characterized by the triad of recurrent hemoptysis, diffuse parenchymal infiltrates, and iron-deficiency anemia [3,4,5]. IPH is usually a diagnosis of exclusion as not one identifying test has been described [6]. Used intensive care therapies include high dose steroid and immunosuppressive treatment along with conventional and high-frequency oscillatory ventilation. In children who cannot maintain adequate oxygenation with conventional therapies extracorporeal life support has been described [6, 8, 9]. The aim of this paper is to present the diagnostic challenge and intensive care unit management of a 6-year-old boy with a severe respiratory failure due to IPH initially presenting as an iron-deficiency anemia
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