Severe Anemia Owing to Occult Pulmonary Hemorrhage

Minkov, Milen; Kovács, Julia; Wiesbauer, P.; Dekan, Gerhard; Gadner, Helmut

doi:10.1097/01.mph.0000212939.89984.d2

Cited by 9 publications

(11 citation statements)

References 8 publications

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“…Plasma ferritin level can elevated because of the alveolar synthesis and release into the circulation and do not reflect the iron deposits of the body. 15 In the our study, all of them had the decreased transferrin saturation and MCV. In contrary of literature, three of our patients had the hypoferritinemia.…”

Section: Discussionsupporting

confidence: 46%

“…13 It is probably due to not only to the lack of hemoptysis, but to the fact that iron deficiency anemia may be the first and the only manifestation of IPH. 14,15 In our patients, the atypical clinical manifestations included presenting with severe anemia are repeated blood transfusions and absence of hemoptysis in four of patients. Our patients had iron deficiency anemia as a only manifestations of IPH.…”

Section: Discussionmentioning

confidence: 65%

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Idiopathic Pulmonary Hemosiderosis Mimicking Iron Deficiency Anemia: A Delayed Diagnosis?

et al. 2017

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Idiopathic pulmonary hemosiderosis (IPH) is an uncommon chronic disorder in children. It is characterized by recurrent pulmonary hemorrhage and may result in hemoptysis and pulmonary insufficiency. The most common hematologic manifestation of IPH is iron deficiency anemia. The etiology of IPH is not known and its diagnosis may be difficult due to the variable clinical courses. The most helpful signs for identifying IPH are iron deficiency anemia and recurrent or chronic cough, hemoptysis, dyspnea, wheezing. We report here 5 pediatric cases of IPH presenting with iron deficiency anemia and without pulmonary symptoms. Mean corpuscular volume was low in all patients; iron was low in 4 out of 5 cases; total iron binding capacity was high in all of them; ferritin was low in 3 patients. At follow up, none of them had responded successfully to the iron therapy. Although they didn’t present with pulmonary symptoms, chest radiographs incidentally revealed diffuse reticulonoduler shadows in all of them. Computed tomography revealed diffuse ground-glass opacities, consolidation, increased density. The diagnosis was confirmed by the detection of hemosiderin-laden macrophages in bronchoalveolar lavage fluid and gastric aspirate. If patients with iron deficiency anemia don’t respond to iron therapy, they should be examined for IPH. Chest radiographs should be taken even in absence of pulmonary symptoms. Early diagnosis is important for a timely management of IPH.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 65%

Idiopathic Pulmonary Hemosiderosis Mimicking Iron Deficiency Anemia: A Delayed Diagnosis?

et al. 2017

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“…A lack of prominent respiratory symptoms does not preclude a diagnosis of DAH. Minkov et al [21] reported a 6-year-old with severe microcytic, hypochromic anemia. After the hematologic evaluation in that patient was nonrevealing, a more careful history uncovered mild cough and exercise intolerance, and chest films and computed tomography confirmed the diagnosis of IPH.…”

Section: Clinical Presentationmentioning

confidence: 98%

Diffuse alveolar hemorrhage syndromes in children

Susarla

Fan

2007

Current Opinion in Pediatrics

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“…1 We have also identified a case of silent IPH, where the presence of atypical features of otherwise characteristic iron-deficiency anemia (IDA)-normal serum ferritin in the absence of systemic inflammation-led to intensive investigation. The eventual diagnosis of IPH was made by carefully targeted assessment of pulmonary irregularities.…”

Section: To the Editormentioning

confidence: 99%