Recurrence of idiopathic pulmonary hemosiderosis in a young adult patient after bilateral single-lung transplantation.
BACKGROUND
Idiopathic pulmonary hemosiderosis (IPH) is a rare disease of unknown etiology characterized by hemoptysis, diffuse pulmonary infiltration, and anemia. Diagnosis requires a detailed clinical history and transbronchial lung biopsy (TLB).


RESULTS
A 19-year-old man developed progressive dyspnea, hemoptysis, and anemia. The chest x-rays showed bilateral opacities. IPH was diagnosed on the basis of clinical findings and TLB. The patient was treated with corticosteroidal therapy. His respiratory function worsened, and he underwent lung transplantation in 1997. The pathological examination on native lungs confirmed the previous histologic diagnosis. In 2000, the patient again developed hemoptysis, fever, and hypoxemia. A recurrence of the disease was established by TLB.


CONCLUSIONS
This is the first report of recurring IPH. The possibility of recurrent IPH raises the question whether these patients should be disqualified from lung transplantation. This question is unanswerable because incidence of recurrence, time course, and impact on the graft function are presently unknown and unpredictable.
Calabrese
Fiorella
F
Department of Pathology, University of Padova, Padova, Italy.
Giacometti
Cinzia
C
Rea
Federico
F
Loy
Monica
M
Sartori
Francesco
F
Di Vittorio
Giuseppe
G
Abudureheman
Aierken
A
Thiene
Gaetano
G
Valente
Marialuisa
M
D000328:Adult; D006486:Hemosiderosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000473:pathology / Q000601:surgery*; D016040:Lung Transplantation; D008297:Male; D012008:Recurrence