Rare causes of anemia in children: Two cases of idiopathic pulmonary hemosiderosis

Jing Yang; Ruo Yan Gou; Xia Ding; Li Li Shao; Gui Xia Ma; Qian Ni

doi:10.1016/j.rmcr.2022.101610

Rare causes of anemia in children: Two cases of idiopathic pulmonary hemosiderosis

Respir Med Case Rep. 2022 Feb 24:36:101610. doi: 10.1016/j.rmcr.2022.101610. eCollection 2022.

Authors

Jing Yang¹, Ruo Yan Gou¹, Xia Ding¹, Li Li Shao¹, Gui Xia Ma¹, Qian Ni¹

Affiliation

¹ Department of Pediatrics, Lanzhou University Second Hospital, Lanzhou, China.

Abstract

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of diffuse alveolar hemorrhage (DAH) with unknown etiology. Hemoptysis, dyspnea, anemia, diffuse infiltration in chest radiography and presence of hemosiderin-loaded macrophages (HLMs) in the sputum, gastric content or bronchoalveolar lavage fluid (BALF) are the major characteristics for diagnosis of IPH. Here we present two pediatric patients with IPH. Patient 1 was repeatly misdiagnosed with bronchopneumonia because of diffuse infiltration in her chest X ray, but her anemia was repeatedly ignored. Patient 2 was misdiagnosed with nutritional anaemia because she did not have dyspnea or hemoptysis, and her chest computed tomography (CT) only revealed mild alveolar infiltrates. IPH must be included in the differential diagnosis in patients with long-term anemia who respond poorly to the hematopoietic supplements. CT is superior to X-ray in detecting alveolar hemorrhage.

Keywords: Anemia; Hemoptysis; Idiopathic pulmonary hemosiderosis (IPH).

Publication types

Case Reports