Idiopathic pulmonary hemosiderosis: A pediatric case report

Background

Idiopathic pulmonary hemosiderosis (IPH) is a rare entity, which needs exclusion of all other possible etiologies. It mainly affects children and young adolescents, but still can come at any age. Despite its rarity, it has many consequences which can lead to significant morbidity if not diagnosed and managed. This report presents the first documented case of IPH in Palestine, highlighting the need for increased awareness and timely recognition of this condition in clinical practice, even in regions where it has not been previously reported.

Case presentation

We report the case of a 14-year-old female diagnosed with IPH at the age of 5. She has a history of recurrent hemoptysis and two intensive care unit (ICU) admissions for diffuse alveolar hemorrhage and acute respiratory distress syndrome (ARDS). Investigations including a high-resolution computed tomography (HRCT) scan of the chest, revealed ground-glass opacities and nodularity. Bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) confirmed the diagnosis of IPH complicated by interstitial lung disease. Management included corticosteroid therapy at first; however, due to suboptimal response, a steroid-sparing immunosuppressive agent was added.

Conclusion

This case is the first reported case of IPH in Palestine, it underscores the importance of recognizing rare diseases in underreported regions. IPH suspicion and diagnosis are challenging. Despite its rarity, it remains one of the causes of diffuse alveolar hemorrhage (DAH). This case highlightes the importance of early recognition and diagnosis of IPH, in order to start an appropriate management strategy and improve outcomes and emphasizes the need for further research into the epidemiology, optimal therapeutic approaches, and long-term outcomes of IPH in diverse populations.