Idiopathic pulmonary hemosiderosis can be diagnosed based on clinical features and sputum examination in resource-limited settings and may respond well to prednisolone therapy.
Supports prednisolone response in this idiopathic pulmonary hemosiderosis case; leaves open efficacy confirmation in prospective trials.
Pulmonary hemosiderosis is an uncommon disorder in pediatric population in developing countries. It may affect the lung in an isolated form of Idiopathic Pulmonary Hemosiderosis (IPH) or as a manifestation of systemic disorders. The present patient belonging to Mongolian race presented with history of fever, cough, respiratory distress and previous episode of hemoptysis. The child had anemia, negative tuberculin test and no acid-fast bacilli in sputum and presence of bilateral pulmonary infiltrates in X-ray chest. Sputum examination showed iron-laden macrophages and no secondary cause could be ascertained. The patient responded well to prednisolone treatment alone. Idiopathic pulmonary hemosiderosis can be diagnosed based on the clinical features and sputum examination. Lung biopsy and high resolution CT thorax may not be undertaken in setting where facilities are not available.
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Gauri Shankar Shah (2012) studied this question.
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