Lane-Hamilton syndrome: case report and review of the literature

Abstract

We report a case of a three-and-a-half-year-old boy, who presented with poor general condition, stunted growth, had the presence of nail clubbing, persistent cough and frequent diarrhoea. Persistent iron deficiency anaemia without signs of haemolysis suggested Lane-Hamilton syndrome (LHS) which is or/is an extremely rare combination of idiopathic pulmonary haemosiderosis (IPH) and celiac disease (CD), although both diseases are immunologically mediated and the pathogenetic link between them is not clear. We have now 3 years of follow-up on gluten-free diet (GFD), resulting in a gradual recovery of the abnormal laboratory results in combination with an improving growth. Clinically, he is asymptomatic without any additional treatment. Our case illustrates that CD should be specifically looked for in patients with IPH, especially those in whom the severity of anaemia is disproportionate to the IPH symptoms. Both diseases may benefit from a GFD.

Extraintestinal manifestations of coeliac disease

“…Unique to coeliac disease is Lane-Hamilton syndrome-a rare and poorly studied condition, in which coeliac disease presents with pulmonary haemosiderosis, generally manifesting as dyspnoea (shortness of breath) and/or haemoptysis (coughing of blood originating from the respiratory tract). 123 Radiological findings typically include dependent opacities and are nonspecific to coeliac disease, as is bronchoscopy. 123 The aetiology of pulmonary manifestations of coeliac disease is unknown but thought to be related to crossreactivity between anti-TG2 antibodies from gut and lungs.…”

“…123 Radiological findings typically include dependent opacities and are nonspecific to coeliac disease, as is bronchoscopy. 123 The aetiology of pulmonary manifestations of coeliac disease is unknown but thought to be related to crossreactivity between anti-TG2 antibodies from gut and lungs. 123 Therapy is generally supportive and symptoms can be expected to resolve with time if the patient adheres to a gluten-free diet.…”

Anemia in Adult Celiac Disease; Presentation with Iron Deficiency Anemia Masked by Colon Cancer

“…In this early report, the anemia responded completely to a gluten-free diet. In children, a rare disorder of iron deficiency anemia with idiopathic pulmonary hemosiderosis and celiac disease has been described, the so-called Lane-Hamilton syndrome [38]. In this report, improvement with a gluten-free diet was noted.…”

Diffuse Lung Disease

“…Other disorders capable of causing pulmonary hemorrhage, such as respiratory tract infections, airway neoplasms, bronchiectasis, coagulopathies, pulmonary venous hypertension, and pulmonary arteriovenous malformations, should be excluded before a diagnosis of IPH is made. IPH is associated with cow's milk allergy (Heiner syndrome) (Moissidis et al 2005), celiac disease (LaneHamilton syndrome) (Hendrickx et al 2011), and Down syndrome (Taytard et al 2013). Imaging findings can include airspace opacities, nodules, septal thickening, cysts, and honeycombing (Fig.…”