Extracorporeal life support for a 5-week-old infant with idiopathic pulmonary hemosiderosis.
Idiopathic pulmonary hemosiderosis is a rare disease defined by the triad of iron deficiency anemia, hemoptysis, and diffuse pulmonary infiltrates on chest radiograph. Idiopathic pulmonary hemosiderosis is known to cause dyspnea and, in some cases, acute onset of massive pulmonary hemorrhage which is traditionally treated with conventional mechanical ventilation or high-frequency oscillation in conjunction with immunosuppressive therapy. In this case report, we describe a 5-week-old infant presenting with hemoptysis, massive pulmonary hemorrhage, and significant hypercapnic respiratory failure. The patient failed conventional ventilation but responded well to extracorporeal life support that was initiated early in his course. Idiopathic pulmonary hemosiderosis was suspected in light of his response to high-dose steroids and was confirmed by subsequent lung biopsies.


CONCLUSIONS
Patients with severe pulmonary hemorrhage secondary to idiopathic pulmonary hemosiderosis can be safely supported with extracorporeal life support when conventional therapies have been exhausted.
Division of Critical Care Medicine , Children's National Medical Center, 111 Michigan Avenue, NW, Washington, DC, 20010, USA.
Sherrill
S
Gutierrez
Susanna
S
Shaw
Shehlanoor
S
Huseni
Shagun
S
Sachdeva
John P
JP
Costello
Sonali
S
Basu
Dilip S
DS
Nath
Darren
D
Klugman
D015199:Extracorporeal Membrane Oxygenation; D006486:Hemosiderosis / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D000097545:Hemosiderosis, Pulmonary