Anaemia and respiratory failure in a child: can it be idiopathic pulmonary haemosiderosis?

BMJ Case Reports
Minhajuddin AhmedAbhay Kumar

Abstract

We present an 8-year-old male child admitted with cough and high-grade fever for 7 days and respiratory difficulty for 2 days. There was a history of blood transfusion at 2 years of age during a respiratory illness. The child was anaemic, tachycardic, tachypnoeic and hypoxic at presentation. Chest examination revealed equal air entry with fine crackles bilaterally. Blood reports were suggestive of anaemia (haemoglobin 6.5 g/dL), leucocytosis and high C reactive protein levels. Chest radiograph revealed bilateral air space opacities involving diffuse lung fields, right more than left. Relevant microbiological workup was negative. Based on the clinical scenario and investigations, a provisional diagnosis of pulmonary haemosiderosis was kept. The patient was started on intravenous pulse methylprednisolone. Fibre-optic bronchoscopy was done following recovery from the acute event. Bronchoalveolar lavage demonstrated a significant number of haemosiderin-laden macrophages confirming pulmonary haemosiderosis.

References

Mar 14, 2008·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Maryam Alrasbi, Aziz Sheikh
Jul 8, 2008·Gastroentérologie Clinique Et Biologique·M KhemiriS Barsaoui
Oct 16, 2013·Orphanet Journal of Rare Diseases·Jessica TaytardUNKNOWN French RespiRare® group
Apr 9, 2014·Italian Journal of Pediatrics·Ilirjana BakalliSashenka Sallabanda
Apr 24, 2015·Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi·K K SiuS Y Lam
Aug 5, 2015·Journal of Pediatric Hematology/oncology·İrem EldemZümrüt Uysal

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