Idiopathic pulmonary haemosiderosis

BMJ Case Rep. 2024 Jun 27;17(6):e261171. doi: 10.1136/bcr-2024-261171.

Abstract

In this paper, we report the case of a boy in early childhood who presented with iron-deficiency anaemia, initially thought to be nutritional, who had a subsequent diagnosis of idiopathic pulmonary haemosiderosis (IPH). This is a slowly progressive and life-threatening disorder and is of paramount importance that this is identified early and treated appropriately. His first chest CT was not typical for IPH, and this appearance should be highlighted (small cystic changes alone initially). He also had focal disease, which allowed us to make the diagnosis using CT-guided biopsy. During his treatment, he experienced an uncommon side effect to a commonly prescribed medication (bradycardia with methylprednisolone). Since starting azathioprine as a steroid-sparing agent, he has been doing well.

Keywords: Interstitial lung disease; Radiology.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Iron-Deficiency / drug therapy
  • Anemia, Iron-Deficiency / etiology
  • Azathioprine / therapeutic use
  • Diagnosis, Differential
  • Hemosiderosis* / diagnosis
  • Hemosiderosis* / drug therapy
  • Hemosiderosis, Pulmonary*
  • Humans
  • Lung Diseases* / diagnosis
  • Lung Diseases* / diagnostic imaging
  • Lung Diseases* / drug therapy
  • Male
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use
  • Tomography, X-Ray Computed*

Substances

  • Azathioprine
  • Methylprednisolone