Silent Idiopathic Pulmonary Hemosiderosis With Iron-deficiency Anemia But Normal Serum Ferritin

Chen, Rong-Long; Chuang, Shih‐Sung

doi:10.1097/mph.0b013e3180950372

Cited by 6 publications

(3 citation statements)

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“…Although IPH and nutritional iron deficiency anemia are characterized by microcytic hypochromic anemia, patients with IPH have normal serum ferritin levels. 26 In the present study, 70 (65.42%) patients had moderate to severe anemia, and this was accompanied by chest imaging abnormalities. Therefore, IPH should be suspected in children with iron deficiency anemia who show no signs of improvement with iron supplementation and with bilateral lung infiltration.…”

Section: Discussionsupporting

confidence: 48%

Clinical characteristics and prognosis of idiopathic pulmonary hemosiderosis in pediatric patients

et al. 2018

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Objective This study aimed to analyze the clinical characteristics and prognosis of pediatric idiopathic pulmonary hemosiderosis (IPH). Methods Pediatric IPH cases that were diagnosed at West China Second University Hospital, Sichuan University between 1996 and 2017 were reviewed. Follow-up data from 34 patients were collected. Results A total of 107 patients were included (42 boys and 65 girls). The median age was 6 years at diagnosis. The main manifestations of the patients were as follows: anemia (n = 100, 93.45%), cough (n = 68, 63.55%), hemoptysis (n = 61, 57%), fever (n = 23, 21.5%), and dyspnea (n = 23, 21.5%). There were relatively few pulmonary signs. The positive rates of hemosiderin-laden macrophages in sputum, gastric lavage fluid, and bronchoalveolar lavage fluid were 91.66%, 98.21%, and 100%, respectively. Seventy-nine patients were misdiagnosed. A total of 105 patients were initially treated with glucocorticoids, among whom 102 survived and three died. Among the followed up patients, two died and 32 survived, among whom 10 presented with recurrent episodes. Conclusions The classic triad of pediatric IPH is not always present. The rates of misdiagnosis and recurrence of IPH are high. Early recognition and adequate immunosuppressive therapy are imperative for improving prognosis of IPH.

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Section: Discussionsupporting

confidence: 48%

Clinical characteristics and prognosis of idiopathic pulmonary hemosiderosis in pediatric patients

et al. 2018

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“…Anaemia is present, caused by the loss of blood to the pulmonary interstitium. Dyspnoea and cough are common in children, with failure to thrive observed in most cases [4, 19]. Adults usually develop dyspnoea and fatigue on exertion, resulting from the development of iron deficiency anaemia.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Pulmonary Hemosiderosis in Adults: A Case Report and Review of the Literature

Τzouvelekis

Ntolios

Oikonomou

et al. 2012

Case Reports in Medicine

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Idiopathic pulmonary hemosiderosis is a very rare condition rarely affecting adults and causing recurrent episodes of diffuse alveolar haemorrhage that may lead to lung fibrosis. Due to lack of pathognomonic findings, IPH diagnosis is established upon exclusion of all other possible causes of DAH in combination with specific pathologic findings revealing bland alveolar haemorrhage with absence of vasculitis and/or accumulation of immune complexes within lung parenchyma. Here we describe a rare case of idiopathic pulmonary hemosiderosis in an otherwise healthy 27-year-old Greek male patient with relapsing episodes of fever accompanied by general fatigue and discomfort. He was at this time point a light smoker and had been hospitalised once in the past for similar symptoms. His iron deficiency anemia coupled with chest high-resolution computed tomography and bronchoalveolar lavage revealed findings compatible with diffuse alveolar hemorrhage. After excluding all other sources of bleeding through extensive gastrointestinal workup and thorough immunologic profile, video-assisted thoracic lung biopsy was performed and the diagnosis of Idiopathic Pulmonary Hemosiderosis was established. Patient was treated with high doses of oral corticosteroids, leading to clinical response. We highlight the need for vigilance by the respiratory physician for the presence of DAH, a challenging, acute condition requiring early recognition along with identification of the underlying syndrome and appropriate treatment to achieve optimal results.

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“…It may lead to iron loss through swallowing of iron-laden alveolar or bronchial epithelial cells. This may lead to functional iron deficiency [76].…”

Section: Idiopathic Pulmonary Hemosiderosis In CDmentioning

confidence: 99%

Complications of Celiac Disease

Jabeen¹

2019

Celiac Disease - From the Bench to the Clinic

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Celiac disease is a small bowel disorder, due to defect in gluten diet, leading to mucosal inflammation, villous atrophy and crypt hyperplasia. For the diagnosis of celiac disease, one has to be on gluten free diet. Due to commonly available various serologic tests and histopathology, celiac disease, can be categorized as asymptomatic, silent or potential. Between 80 and 90% of all patients with celiac disease remained undiagnosed. Because of this late diagnosis, patients may develop various complications including anemia, bone loss, depression and cancers. Patients may have different types of anemia including iron deficiency, folic acid or B12 deficiency. Any of these may occurred separately or may be manifested together. The same variation is seen in bone loss, starting from osteopenia, osteomalacia to osteoporosis and even dysplasias. Patient may develop lymphoma, gastric or oesophageal carcinomas as well. Celiac disease is also associated with other autoimmune illnesses as it is an autoimmune process by itself. The complications of celiac disease, is either due to direct consequence of celiac, or due to significant damage to the small intestine. With the early detection and diagnosis, the symptomatology and complications of celiac disease can be spared.

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Silent Idiopathic Pulmonary Hemosiderosis With Iron-deficiency Anemia But Normal Serum Ferritin

Cited by 6 publications

References 5 publications

Clinical characteristics and prognosis of idiopathic pulmonary hemosiderosis in pediatric patients

Clinical characteristics and prognosis of idiopathic pulmonary hemosiderosis in pediatric patients

Idiopathic Pulmonary Hemosiderosis in Adults: A Case Report and Review of the Literature

Complications of Celiac Disease

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