Idiopathic pulmonary hemosiderosis - A rare cause of chronic anemia

  • Ayesha Butt | ayeshabutt21@outlook.com Aga Khan University Medical College, Karachi, Pakistan. https://orcid.org/0000-0003-1172-2159
  • Rashida Ahmed Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.
  • Muhammad Dawood Amir Sheikh Aga Khan University Medical College, Karachi, Pakistan. https://orcid.org/0000-0002-5029-4161
  • Omar Khan Jinnah Sindh Medical University, Karachi, Pakistan. https://orcid.org/0000-0003-3685-2355
  • Nousheen Iqbal Jinnah Sindh Medical University; 4Department of Medicine, Section of Pulmonary and Critical Care, Aga Khan University, Karachi, Pakistan.
  • Arshalooz Jamila Rahman Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
  • Javaid Ahmed Khan Department of Medicine, Section of Pulmonary and Critical Care, Aga Khan University, Karachi, Pakistan.

Abstract

Idiopathic pulmonary hemosiderosis (IPH) is a rare disease marked by alveolar bleeding and accumulation of hemosiderin in the lungs. Here we present three cases of IPH. The first case is of a 26-year-old male with anemia, hemoptysis and dyspnea. Bronchoscopy confirmed diffuse alveolar hemorrhage (DAH). A diagnosis of IPH was made after ruling out other causes of DAH and observing good response to steroids. The patient’s condition improved with prednisolone and azathioprine. The second case is of 26-year-old female with severe anemia. Imaging suggested IPH and lung biopsy confirmed it. She died shortly afterwards. The third case is of a 7-year-old male with chronic anemia. CT was suggestive of IPH and lung biopsy confirmed the diagnosis. Later, patient developed posterior reversible encephalopathy syndrome (PRES). This patient is stable on azathioprine and prednisolone. We aim to emphasize the importance of considering IPH as a differential in patients with DAH or chronic anemia.

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Published
2020-06-09
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Issue
Section
Pneumology - Case Reports
Keywords:
Hemoptysis, anemia, lung diseases
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How to Cite
Butt, A., Ahmed, R., Sheikh, M. D. A., Khan, O., Iqbal, N., Rahman, A. J., & Khan, J. A. (2020). Idiopathic pulmonary hemosiderosis - A rare cause of chronic anemia. Monaldi Archives for Chest Disease, 90(2). https://doi.org/10.4081/monaldi.2020.1267