Idiopathic pulmonary hemosiderosis is a rare respiratory disease that often beginning before the age of 10 years. In the pediatric population, it can be manifested only by isolated iron deficiency anemia, without association of other symptoms, sometimes with late diagnosis. We will present a clinical case of pulmonary hemosiderosis with metabolic damage, characterized by the accumulation of hemosiderin in alveolar macrophages and increased levels of ferritin. The progression of lung dysfunction is evaluated imaging by lung CT.