Salcido PPA, Baños SC, Reyes CGC, Munguía MD, Amador MJE, Vázquez GJC, Santillán DP

Language: Spanish
References: 16
Page: 288-292
PDF size: 436.98 Kb.

ABSTRACT

Background: Idiopathic pulmonary hemosiderosis has a prevalence of 20%. It is not certain its etiology. The physiopathology describes alveolar macrophages that accumulate big amounts of iron. The clinical triad is hemoptysis, pulmonary infiltrates, and anemia. The histopathological diagnosis is realized when the pulmonary biopsy excludes vasculitis, granulomas and immune deposits. The principal cause of death is acute respiratory failure secondary to massive alveolar hemorrhage. This is a disease that is not frequently diagnosed because of its complex manifestations and its similarity to other pulmonary diseases.
Clinical case: Men of 45 years, with multiple blood transfusions, chronic renal failure, hypertension, diabetes mellitus, ischemic heart disease, and chronic heart failure. He has history of recurrent hospitalizations before hemodialysis characterized by fever of 39°C and hemoptysis, chest x-ray with pulmonary hypertension and diffuse opacities with reticulonodular design, and CT image with honeycombing and ground-glass attenuation. Pulmonary biopsy reported pulmonary hemosiderosis and cryptogenic organizing pneumonia. He was treated with steroids with a good response. He leaves to another hospital where he dies secondary to a lethal arrhythmia caused by hypoxia.
Conclusion: Idiopathic pulmonary hemosiderosis is a rare disease. To make a diagnosis is necessary to exclude other causes of diffuse alveolar hemorrhage. Multiple treatments have been studied, but the combination of azathioprine with steroids has a better response.

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