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BMJ Case Reports 2017; doi:10.1136/bcr-2017-219431
  • Rare disease
  • CASE REPORT

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

  1. Abhay Kumar
  1. Department of Pediatrics, Holy Family Hospital, New Delhi, India
  1. Correspondence to Dr Dinesh Raj, dr_aiims{at}yahoo.co.in
  • Accepted 14 April 2017
  • Published 15 May 2017

Summary

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.

Footnotes

  • Contributors All authors: involved in the clinical management of the patient. AK and AsK: performed literature search. DR and MA: involved in manuscript writing.

  • Competing interests None declared.

  • Patient consent Obtained from guardian.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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