Idiopathic Pulmonary Hemosiderosis in Adult:2 Misdiagnosed Cases Analysis and Literature Review

TAN Xiang-lan; MEI Tong-hua

doi:10.3969/j.issn.1002-3429.2017.11.002

Abstract：Objective To investigate clinical features, therapeutic methods, misdiagnosed causes and prevention measures of idiopathic pulmonary hemosiderosis ( IPH) in adult. Methods Clinical data of 2 adult misdiagnosed patients with IPH was retrospectively analyzed, and related literature was also reviewed. Results A elderly female patient was admit-ted for cough and expectoration for 5 years, short breath for 1 year, aggravation for 12 d and hemoptysis for 3 d, and was diag-nosed as having upper respiratory tract infection, pulmonary infection and so on in other hospitals, and the patient was diag-nosed as having chronic obstructive lung disease in acute exacerbation period combined with pulmonary infection by related ex-aminations after admission in our hospital, but the patient 's condition did not improved after corresponding treatment for 1 week. The other patient was admitted for fatigue for 1 month associated by dyspnea and Labored breathing, headaches and fe-ver for 4 d, and was diagnosed as having pulmonary infection combined with iron-deficiency anemia in local hospital, and the patient's condition slightly improved after corresponding treatment, and the patient was diagnosed as having type I respiratory failure and pneumocystis pneumonia ( PCP) by related examinations after admission in our hospital, but the curative effect was poor by experienced anti-infection treatment. Abundant hemosiderin-laden macrophage was found by bronchoalveolar lavage, and secondary pulmonary hemorrhage was disaffirmed after performing related examinations simultaneously, and then adult IPH was confirmed in the 2 patients. Conditions of the 2 patients were improved after corresponding treatments of glucocorticoid and erythrocyte suspension transfusion respectively. Conclusion Clinicians should consider the possibility of IPH when patients have bilateral pulmonary infiltration lesions combined with anemia with whether having hemoptysis or not, and bronchoscopy is valuable in diagnosis.