Kocakoc Ercan, Kiris Adem, Sen Yasar, Bozgeyik Zulkif
Department of Radiology, Faculty of Medicine, Firat University, Elazig, Turkey.
Med Princ Pract. 2003 Apr-Jun;12(2):129-32. doi: 10.1159/000069112.
Idiopathic pulmonary hemosiderosis (IPH) is an uncommon disorder, which is characterized by recurrent hemoptysis, iron deficiency anemia and diffuse parenchymal infiltration on chest radiographs in pediatric patients. We wish to present clinical and radiological (plain radiography and CT) findings of this rare pathology.
A 14-year-old girl was admitted to the pediatric emergency department with complaints of cough, dyspnea, fatigue and bloody sputum for 6 months. She had been hospitalized 3 times during this period and received antibiotics and blood transfusion. Chest X-rays revealed prominent perihilar and bibasilar consolidation. CT showed a ground glass pattern and consolidated areas with increased density. Sputum analysis yielded hemosiderin-laden macrophages. With presumptive diagnosis of IPH, prednisolone was administered. Her symptoms improved on the 5th day of treatment and 1 month later, plain chest radiography demonstrated marked improvement.
Although IPH is a rare condition, the diagnosis of IPH should be considered, among others, in a patient with hemoptysis and bilateral infiltration in the chest X-ray. This may prevent antibiotic misuse and risk of death due to severe hemorrhage.
特发性肺含铁血黄素沉着症（IPH）是一种罕见疾病，其特征为儿科患者反复咯血、缺铁性贫血以及胸部X线片显示弥漫性实质浸润。我们希望展示这种罕见病理的临床及放射学（X线平片和CT）表现。
一名14岁女孩因咳嗽、呼吸困难、乏力及咯血6个月入住儿科急诊科。在此期间她曾3次住院，接受过抗生素治疗及输血。胸部X线片显示肺门周围及双肺基底段明显实变。CT显示磨玻璃样影及密度增高的实变区域。痰液分析发现含铁血黄素巨噬细胞。初步诊断为IPH后，给予泼尼松龙治疗。治疗第5天她的症状有所改善，1个月后胸部X线平片显示明显好转。
尽管IPH是一种罕见疾病，但对于咯血且胸部X线片显示双侧浸润的患者，尤其应考虑IPH的诊断。这可能避免抗生素的滥用以及因严重出血导致的死亡风险。
