José P. Unda-Haro, Pediatría, Grupo Médico Pediátrico, Ciudad de México, México
Ma. Isabel Peinado-Fabregat, General Pediatrics, Stanford School of Medicine, Palo Alto, California, United States; Academic Pediatric Association; Ciudad de México, México
Juan R. Osegueda-Mayen, Pediatría y Neonatología, Grupo Médico Pediátrico. Ciudad de México, México
Idiopathic pulmonary hemosiderosis is a rare disease that usually presents in children and is characterized by recurrent pulmonary hemorrhages which cause the triad of hemoptysis, anemia, and pulmonary infiltrates on imaging studies. We present a clinical case of a 17-month-old male who presented with cough, respiratory distress, and requiring supplemental oxygen to maintain adequate oxygen saturation. Imaging studies were significant for a diffuse interstitial pattern, which prompted a bronchoscopy, where hemosiderin laden macrophages were found. First line of treatment was started with immunomodulators as well as anti-inflammatories such as topical and systemic steroids. Due to the poor therapeutic response, a pulmonary biopsy was pursued which demonstrated episodes of recent bleeding and specific histopathological changes confirming the diagnosis of early idiopathic pulmonary hemosiderosis.
Keywords: Cough. Hemosiderosis. Pneumonia.