title: Pulmonary hemosiderosis in children with bronchopulmonary dysplasia.
abstract: We describe a possible association between pulmonary hemosiderosis (PH) and a history of bronchopulmonary dysplasia (BPD). Both patients were born at 28-week gestation and presented with PH at ages 22 months and 6 years, respectively. Both initially presented with cough and tachypnea, and bronchoalveolar lavage showed evidence of hemosiderin-laden macrophages. Initial hemoglobin levels were < 4 g/dL and chest radiographs showed diffuse infiltrates that cleared dramatically within days after initiation of intravenous corticosteroids. In the first case, frank pulmonary blood was observed upon initial intubation, prompting the need for high frequency ventilation, immediate corticosteroids, and antibiotics. The mechanical ventilation wean was made possible by the addition of mycophenolate mofetil (MMF) and hydroxychloroquine. Slow tapering off of medications was accomplished over 6 years. These cases represent a possible correlation between prematurity-associated BPD and PH. We present a review of the literature regarding this possible association. In addition, MMF proved to be life-saving in one of the PH cases, as it has been in pulmonary hemorrhage related to systemic lupus erythematosus. Further studies are warranted to investigate the possible association between PH and prematurity-related BPD, as well as the use of MMF in the treatment of PH.
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Kurahara
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Marina
authors.initials: M
authors.lastname: Morie
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Maya
authors.identifier: 0000-0002-7464-8008
authors.initials: M
authors.lastname: Yamane
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Sarah
authors.identifier: 0000-0001-5802-1953
authors.initials: S
authors.lastname: Lam
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Wallace
authors.initials: W
authors.lastname: Matthews
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Keolamau
authors.initials: K
authors.lastname: Yee
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Kara
authors.identifier: 0000-0003-3110-6986
authors.initials: K
authors.lastname: Yamamoto