title: Anemia as the sole presenting symptom of idiopathic pulmonary hemosiderosis: report of two cases.
abstract: Idiopathic pulmonary hemosiderosis (IPH) is a rare disease in children and has an unknown etiology. It is characterized by the triad of hemoptysis, pulmonary infiltrates on chest radiograph (CXR) and iron deficiency anemia. We report two young children, aged 3 and 4 years, were admitted due to pale-looking appearance but without hemoptysis or other respiratory symptoms. Pallor was the sole presenting feature in these 2 children with IPH and which was unusual. CXR obtained on admission led to the suspicion of pulmonary hemorrhage. The diagnosis of IPH was confirmed based on the presence of many hemosiderin-laden macrophages in bronchoalveolar lavage fluid obtained by flexible bronchoscopy. Steroid was initiated after the diagnosis of IPH was established; the both of them have been well and received regular follow-up in our outpatient department. IPH may not be diagnosed because of difficulty in diagnosis. Anemia may be the only presenting feature of IPH, which was due to occult pulmonary hemorrhage. Initial treatment with corticosteroids has been successful in our patients for a period of 6 and 8 months of follow up respectively.
authors.affiliation: Division of Pediatric Pulmonology, Department of Pediatrics, Chang-Gung Memorial Hospital, Kaohsiung.
authors.forename: Kao-Chun
authors.initials: KC
authors.lastname: Chen
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsiao
authors.forename: Shun-Chen
authors.initials: SC
authors.lastname: Huang
authors.forename: Sheung-Fat
authors.initials: SF
authors.lastname: Ko
authors.forename: Chen-Kuang
authors.initials: CK
authors.lastname: Niu
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000740:Anemia / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D006486:Hemosiderosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008171:Lung Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male
chemical_list: D000305:Adrenal Cortex Hormones