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

Chen, Xiyuan; Sun, Jin-Ming; Huang, Xiao‐Jun

doi:10.1111/crj.12440

Cited by 44 publications

(40 citation statements)

References 24 publications

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“…However, the number of feline cases was relatively small, limiting the conclusions that could be drawn regarding the association of hemosiderosis with particular conditions, types of pulmonary disease, and the absence of pulmonary disease. A cause for pulmonary hemosiderosis is not always identified in humans, and various environmental factors such as inhalation of mold spores have been implicated . Although chronic exposure to toxic mold has been associated with severe pulmonary hemorrhage under anesthesia in two cats, a potential relationship between environmental agents and frequency of hemosiderosis in cats and dogs remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

“…The conditions prior to BAL procedures that were specifically recorded were the presence of gastrointestinal (GI) diseases, autoimmune diseases, neoplasia, and osteoarthrosis. These diseases have been reported to be associated with pulmonary hemosiderosis in human medicine . A previous diagnosis of GI disease was based on vomiting and/or diarrhea for a 1‐week duration or longer.…”

Section: Methodsmentioning

confidence: 99%

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Bronchoalveolar lavage hemosiderosis in dogs and cats with respiratory disease

Hooi

Defarges

Jelovcic

et al. 2019

Veterinary Clinical Pathol

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Background: Hemosiderophages can be found in bronchoalveolar lavage samples and have been reported in association with a wide range of respiratory and cardiovascular disorders in cats and humans.Objectives: This study aimed to retrospectively evaluate the presence of hemosiderin in canine and feline bronchoalveolar lavage (BAL) samples. It also aimed to examine the association of BAL hemosiderin with signalment, clinical signs, and historical disease prior to BAL, with prior transthoracic fine-needle aspiration (FNA), with bronchoalveolar lavage duration, and with cytologic interpretation. Methods:The medical records of dogs and cats with respiratory disease that underwent BAL between 2007 and 2016 were reviewed. Appropriate medical information and BAL results were available from 171 dogs and 34 cats. Cases were assigned to four disease categories based on BAL cytologic findings: pneumonia, inflammatory disease, neoplasia, or normal airways. The degree of hemosiderosis was classified based on a semi-quantitative scoring scale. Exact logistic regression analysis was used to evaluate the relationship between risk factors and the presence of BAL hemosiderosis on cytology. Results:Hemosiderin was identified in 13/171 (7.6%) canine samples and 18/34 (52.9%) feline samples. Cats were 13.33 times more likely to have pulmonary hemosiderosis on bronchoalveolar lavage cytology compared with dogs (P < 0.001).Increased respiratory rates, prolonged bronchoalveolar lavage times, concurrent transthoracic FNAs, and cytologic diagnoses were associated with an increased risk of hemosiderosis in dogs. No specific risk factors associated with pulmonary hemosiderosis in cats were identified. Conclusions:Hemosiderosis is more common in BAL samples from cats than from dogs and is associated with a diverse range of disease conditions. K E Y W O R D Scanine, feline, hemosiderophage, hemosiderosis, pulmonary, respiratory disease

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Bronchoalveolar lavage hemosiderosis in dogs and cats with respiratory disease

Hooi

Defarges

Jelovcic

et al. 2019

Veterinary Clinical Pathol

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“…The pulmonary symptomatology in LHS starts usually in childhood, and only 25% of all patients have an adult onset [14,35]. Xi-Yuan et al reviewed the literature for IPH and identified 37 patients (12 women, 24 men), out of whom 5 had CD [64]. In children with IPH, about 30% might have associated CD [65].…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature

Dima

Jurcuţ²,

Manolache³

et al. 2018

JGLD

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Background & Aims: Celiac disease (CD) presents with a wide spectrum of extra-digestive symptoms, including hemorrhagic manifestations. The aim of this review was to conduct an extensive analysis of the hemorrhagic events reported in adult CD patients.Methods: Case report and review of the literature. Pubmed (MEDLINE) database search from January 1970 onwards was performed using the medical subject headings [MeSH] terms “celiac disease” AND “blood coagulation disorders”, “hemorrhage”, “hematoma”, “hematuria”, “hemoptysis”, “epistaxis”, “hemosiderosis”.Only case reports were identified on the search theme. Information on patients’ characteristics, diagnostic features, coagulation parameters, symptomatology duration, and evolution under treatment were systematically collected and summarized.Results: We present the case of a 40-year-old man hospitalized for spontaneous muscular hematomas, in whom CD was diagnosed. We performed a review of the literature and summarized the published case reports of 46 CD patients, aged between 19 and 74 years, 64% of male gender. In 25% of cases, the symptomatology was present for more than 5 years prior to CD diagnosis. The clinical hemorrhagic events were as follows: 15 patients had gastrointestinal bleeding, 9 hemoptysis, 4 epistaxis, 6 hematuria, 8 cutaneous hematoma, petechia or ecchymoses, and only in 1 case hemarthrosis, hemorrhagic vesicular dermatitis, subcortical hemorrhage, or adrenal hemorrhage. Sixty percent of the patients had digestive symptoms, while the rest had only extradigestive CD involvement. The Lane Hamilton syndrome was defined in 15 patients. The evolution under a gluten-free diet was favorable in most cases.Conclusion: This review of case reports aims to increase awareness to hemorrhagic events, rare but possible life-threatening conditions, as part of the CD clinical spectrum. To the best of our knowledge, this is the first review of all types of hemorrhagic events in adult CD patients.

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“…Idiopathic Pulmonary Hemosiderosis is treated with systemic corticosteroids with or without other immunosuppressant. 15 DAH is often misdiagnosed as radiology mimics other alveolar filling processes such as infection and pulmonary edema. The low index of suspicion is another cause of delayed diagnosis.…”

Section: A 4bmentioning

confidence: 99%

Diffuse Alveolar Haemorrhage: A Single Centre Experience

Dhungana

Shrestha

2019

Nep. Med. J.

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Introduction: Diffuse alveolar hemorrhage results from an accumulation of red blood cells into the alveolar space. Symptoms of alveolar hemorrhage are dyspnea, hemoptysis, anemia, diffuse pulmonary infiltrates and hypoxemic respiratory failure. Diagnosis is established by bronchoalveolar lavage and treatment includes a combination of high dose systemic corticosteroids, immunosuppressant and plasma exchange. The aim of this study is to evaluate the clinical radiological profile and laboratory findings and utility of bronchoalveolar lavage in the diagnosis of diffuse alveolar hemorrhage.Materials and Methods: In a retrospective review between February 2017 and December 2017, medical records of patients with a diagnosis of diffuse alveolar hemorrhage presenting at the National Academy of Medical Sciences, Kathmandu, Nepal, were analyzed. Clinical, radiology and laboratory results along with bronchoalveolar lavage results were extracted. Treatment received and clinical responses were evaluated.Results: A total of five patients were diagnosed to have diffuse alveolar hemorrhage based on bronchoalveolar lavage analysis. Three had hemorrhage secondary to Antineutrophil Cytoplasmic Antibody associated vasculitis, one had Systemic Lupus Erythematosus and the other Idiopathic Pulmonary Hemosiderosis. Renal involvement was present in three patients. All patients received systemic corticosteroids, three received Cyclophosphamide and one Rituximab for remission induction. Plasma exchange was done in two patients with severe hypoxemia. Of the five patients, four improved whereas one died.Conclusions: Diffuse alveolar hemorrhage presents with non-specific symptoms. Bronchoalveolar lavage is extremely useful to establish the diagnosis and exclude infections. Early initiation of immunosuppressant prevents respiratory failure and death.

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

Cited by 44 publications

References 24 publications

Bronchoalveolar lavage hemosiderosis in dogs and cats with respiratory disease

Bronchoalveolar lavage hemosiderosis in dogs and cats with respiratory disease

Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature

Diffuse Alveolar Haemorrhage: A Single Centre Experience

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