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Hemosiderosis

Bleeding in the lungs causes damage

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Updated September 21, 2003

What is it?
Pulmonary hemosiderosis is a lung disorder in which bleeding (hemorrhage) into the lungs leads to abnormal accumulation of iron. This causes anemia and lung damage. There are three types of hemosiderosis:
  • Group 1 – pulmonary hemorrhage and autoimmune disorder affecting kidneys and lungs (Goodpasture syndrome)
  • Group 2 – pulmonary hemorrhage and immune disease, such as systemic lupus erythematosus, Henoch-Schonlein purpura, or connective tissue disease. Sometimes it is associated with sensitivity to cow’s milk (Heiner syndrome)
  • Group 3 – pulmonary hemorrhage but no immune disease. Hemosiderosis may be associated with other disorders or may have no known cause (idiopathic).

Symptoms
There are three main symptoms of pulmonary hemosiderosis: coughing up blood (hemoptysis), iron deficiency anemia, and lung tissue changes. The symptoms may begin slowly or come on quickly. Idiopathic pulmonary hemosiderosis may occur in people of any age but is usually diagnosed in children aged 1-7 years. Goodpasture syndrome usually occurs in young adult males. Heiner syndrome is usually diagnosed in infancy.

If hemosiderosis comes on slowly, symptoms may develop such as chronic fatigue, poor growth in children, cough that doesn’t go away, and persistent runny nose.

Diagnosis
If the symptoms suggest hemosiderosis, a blood test for iron and chest x-ray may help confirm the diagnosis. A tube can be inserted into the lungs and tissue can be tested for iron build-up.

Treatment
If the person is bleeding in his lungs, treatment will focus on respiratory therapy, oxygen, immunosuppression, and blood transfusion if necessary. Milk sensitivity is treated by removing all milk and milk products from the diet; this may completely clear up the bleeding. If hemosiderosis is due to another disorder, treating the underlying condition will lessen the bleeding. Studies have not resolved the question of whether using immunosuppressive drugs such as prednisone is useful for long-term treatment of hemosiderosis.

Information for this article was taken from:
Napchan, G. D. (2002). Hemosiderosis. eMedicine, accessed at http://www.emedicine.com/ped/topic970.htm

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