Idiopathic Pulmonary Hemosiderosis: Favorable Response to Corticosteroids

Abstract

A 50-year-old Taiwanese woman had a history of massive hemoptysis occurring every 6 months for the past 4 years. After each bout of hemoptysis, chest roentgenography would show diffuse alveolar infiltration of bilateral lungs, which would usually resolve within 7 days. Transbronchial biopsy revealed diffuse alveolar hemorrhage and hemosiderin-laden macrophage infiltration. Idiopathic pulmonary hemosiderosis was diagnosed by excluding other glomerular, cardiac and immunological disorders. An initial dose of 20 mg prednisolone daily was tapered to 10 mg daily 1 month later. The patient is currently undergoing steroid therapy, and there have been no further episodes of hemoptysis.

Idiopathic pulmonary hemosiderosis in adults: review of cases reported in the latest 15 years

“…A total of 37 patients (24 males and 13 females) were included from 25 reports . The median age at diagnosis was 34 years (18–83 years), and 21 (57%) patients were diagnosed after the age of 30 years.…”

Idiopathic pulmonary hemorrhage: morphology and differential diagnosis. Case report

“…Long-term IPH may lead to interstitial fibrosis. By definition, IPH does not present renal involvement, immune complexes, and antineutrophil cytoplasmic antibody (ANCAS) (1,3,4,8,10,11,17,18,21) . IPH diagnosis is made on the basis of clinical, radiologic, laboratorial and histopathological findings.…”

“…Some patients develop repeated episodes of hemoptysis, or persistent dyspnea and anemia (5,11,21,26) . The use of corticosteroids must be considered, but the response is variable (1,3,8,12) . A good prognosis is expected in this case, although the possibility of short episodes of recurrence must be considered.…”

“…The patients present recurrent episodes of pulmonary hemorrhage, which may occasionally determine ventilatory restriction. The clinical presentation is extremely variable, and the most common symptoms include iron deficiency anemia, diffuse pulmonary infiltrates, and hemoptysis (3,8,10,11,25) .…”

Idiopathic pulmonary hemosiderosis with dendriform pulmonary ossification

“…La administración de corticoides debe iniciarse con una dosis de 1 a 2 mg/kg diarios por vía intravenosa en los casos graves, la cual deberá disminuirse a la dosis de mantenimiento de 0,5 a 0,75 mg/kg diarios durante18 a 24 meses (12,13).…”