Abstract
Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of recurrent episodes of
diffuse alveolar hemorrhage (DAH). IPH commonly manifests with hemoptysis, radiologic
chest infiltrates and anemia. The etiology of IPH is unknown, but an immunologic mechanism
is widely speculated. The definitive diagnosis of IPH requires a thorough exclusion
of other causes of DAH, such as infections, inflammation, malignancy, cardiac diseases,
drug and toxin exposure, and medications. Due to the rarity of the disease, a diagnosis
is often delayed by years. We present the case of a 49-year-old man with ischemic
cardiomyopathy who presented with hemoptysis for eighteen months. Serologic workup
was negative for vasculitides and autoimmune diseases. Bronchoscopy revealed DAH.
A surgical lung biopsy showed ‘bland pulmonary hemorrhage.’ A right heart catheterization
ruled out cardiac causes of DAH. The patient was diagnosed with IPH and started on
systemic corticosteroids with rapid improvement of hemoptysis.
Key Indexing Terms
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Article info
Publication history
Published online: March 08, 2022
Accepted:
October 21,
2021
Received:
March 17,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
