一例儿童特发性肺含铁血黄素沉着症诊疗观察
Clinical Observation of Children’s Idiopathic Pulmonary Hemosiderosis: A Case Report

DOI: 10.12677/ACRP.2016.43004, PP. 17-22

Keywords: 特发性肺含铁血黄素沉着症，儿童，诊断，治疗
Idiopathic Pulmonary Hemosiderosis, Children, Diagnosis, Treatment

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的：探讨原发性肺含铁血黄素沉着症原因和治疗方法。方法：对我科发现一例特发性肺含铁血黄素沉着症病例进行临床资料的回顾分析。结果：患儿因反复咳血丝痰一年余来我院住院，CT显示肺部团片状磨玻璃影，肺泡灌洗液可见含铁血黄素巨噬细胞。长期口服激素治疗后无咳血丝痰，CT显示病变吸收。结论：儿童出现反复咯血，不管是否合并贫血，我们应该积极考虑原发性肺含铁血黄素沉着症的可能，进行早期鉴别诊断和治疗。
Object: The objective was to investigate the causes and treatment of idiopathic pulmonary hemosiderosis. Method: The clinical data of one child with the disease of idiopathic pulmonary hemosiderosis in our department were retrospectively analyzed. Result: The child was transferred to our department because of coughing the sputum with blood streaks repeatedly, and the CT showed the mass-like and ground-glass-like shadow of lung. We can find siderophages in the bronchoalveolar lavage fluid. After the treatment of oral corticosteroid in long term, the child hasn’t coughed the sputum with blood streaks again and the CT showed that the lesion has been absorbed. Conclusion: Whether the child is combining anemia or not, if he has hemoptysis repeatly, we should consider that he is possible to have the disease of idiopathic pulmonary hemosiderosis and have differential diagnosis and treat him early.

References

[1]	Kjellman, B., Elinder, G., Garwicz, S., et al. (1984) Idiopathic Pulmonary Haemosiderosis in Swedish Children. Acta Paediatrica Scandinavica, 73, 584-588.
[2]	Ohga, S., Takahashi, K., Miyazaki, S., et al. (1995) Idiopathic Pulmonary Haemosiderosis in Japan: 39 Possible Cases from a Survey Questionnaire. European Journal of Pediatrics, 154, 994-995.
[3]	Ioachimescu, O.C., Sieber, S. and Kotch, A. (2004) Idiopathic Pulmonary Haemosiderosis Revisited. European Respiratory Journal, 24, 162-170. http://dx.doi.org/10.1183/09031936.04.00116302
[4]	Le Clainche, L., Le Bourgeois, M., Fauroux, B., et al. (2000) Long-Term Outcome of Idiopathic Pulmonary Hemosiderosis in Children. Medicine (Baltimore), 79, 318-326. http://dx.doi.org/10.1097/00005792-200009000-00005
[5]	Gutierrez, S., Shaw, S., Huseni, S., et al. (2014) Extracorporeal Life Support for a 5-Week-Old Infant with Idiopathic Pulmonary Hemosiderosis. European Journal of Pediatrics, 173, 1573-1576. http://dx.doi.org/10.1007/s00431-013-2130-4
[6]	Limme, B., Nicolescu, R. and Misson, J.P. (2014) Neonatal Pulmonary Hemosiderosis. Case Reports in Pediatrics, 2014, 463973.
[7]	Agata, H., Kondo, N., Fukutomi, O., et al. (1997) Pulmonary Hemosiderosis with Hypersensitivity to Buckwheat. Annals of Allergy, Asthma & Immunology, 78, 233-237. http://dx.doi.org/10.1016/S1081-1206(10)63394-7
[8]	Morgan, P.G. and Turner-Warwick, M. (1981) Pulmonary Haemosiderosis and Pulmonary Haemorrhage. British Journal of Diseases of the Chest, 75, 225-242. http://dx.doi.org/10.1016/0007-0971(81)90001-2
[9]	Bhatia, S., Tullu, M.S., Vaideeswar, P., et al. (2011) Idiopathic Pulmonary Hemosiderosis: Alveoli Are an Answer to Anemia. Journal of Postgraduate Medicine, 57, 57-60. http://dx.doi.org/10.4103/0022-3859.74290
[10]	Khorashadi, L., Wu, C.C., Betancourt, S.L., et al. (2015) Idiopathic Pulmonary Haemosiderosis: Spectrum of Thoracic Imaging Findings in the Adult Patient. Clinical Radiology, 70, 459-465. http://dx.doi.org/10.1016/j.crad.2014.11.007
[11]	陈和斌, 陆小霞, 蒋鲲. 儿童反复咯血的病因及临床诊治分析[J]. 中国当代儿科杂志, 2014, 16(03): 281-284.
[12]	蔡栩栩, 尚云晓. 特发性肺含铁血黄素沉着症诊断和治疗进展[J]. 实用儿科临床杂志, 2011, 26(16): 1231-1234.
[13]	Nacaroglu, H.T., Sandal, O.S., Bag, O., et al. (2015) Association of Celiac Disease with Idiopathic Pulmonary Hemosiderosis. Lane Hamilton Syndrome. Iranian Journal of Pediatrics, 25, e3312. http://dx.doi.org/10.5812/ijp.3312
[14]	Sethi, G.R., Singhal, K.K., Puri, A.S., et al. (2011) Benefit of Gluten-Free Diet in Idiopathic Pulmonary Hemosiderosis in Association with Celiac Disease. Pediatric Pulmonology, 46, 302-305. http://dx.doi.org/10.1002/ppul.21357
[15]	Torres, M.J., Giron, M.D., Corzo, J.L., et al. (1996) Release of Inflammatory Mediators after Cow’s Milk Intake in a Newborn with Idiopathic Pulmonary Hemosiderosis. Journal of Allergy and Clinical Immunology, 98, 1120-1123. http://dx.doi.org/10.1016/S0091-6749(96)80201-6
[16]	陈霞, 侯振洲. 儿童特发性肺含铁血黄素沉着症HRCT表现分析[J]. 医学影像学杂志, 2015(06): 1112-1114.
[17]	李海燕. 儿童特发性肺含铁血黄素沉着症的CT表现[J]. 中国药物与临床, 2013, 13(08): 1047-1048.
[18]	Green, R.J., Ruoss, S.J., Kraft, S.A., et al. (1996) Pulmonary Capillaritis and Alveolar Hemorrhage. Update on Diagnosis and Management. Chest, 110, 1305-1316. http://dx.doi.org/10.1378/chest.110.5.1305
[19]	Kiper, N., Gocmen, A., Ozcelik, U., et al. (1999) Long-Term Clinical Course of Patients with Idiopathic Pulmonary Hemosiderosis (1979-1994): Prolonged Survival with Low-Dose Corticosteroid Therapy. Pediatric Pulmonology, 27, 180-184. http://dx.doi.org/10.1002/(SICI)1099-0496(199903)27:3<180::AID-PPUL5>3.0.CO;2-8
[20]	Gencer, M., Ceylan, E., Bitiren, M. and Koc, A. (2007) Two Sisters with Idiopathic Pulmonary Hemosiderosis. Canadian Respiratory Journal, 14, 490-493. http://dx.doi.org/10.1155/2007/150926
[21]	Sherani, K.M., Upadhyay, H.N., Sherani, F.K., et al. (2015) Idiopathic Pulmonary Hemosiderosis Presenting in an Adult: A Case Report and Review of the Literature. Lung India, 32, 395-397. http://dx.doi.org/10.4103/0970-2113.159594
[22]	Inayama, M., Hino, H., Takezaki, A., et al. (2007) [A Case of Adult Onset Idiopathic Pulmonary Hemosiderosis Markedly Improved by Steroid Therapy]. Nihon Kokyuki Gakkai Zasshi, 45, 971-976.
[23]	Taytard, J., Nathan, N., de Blic, J., et al. (2013) New Insights into Pediatric Idiopathic Pulmonary Hemosiderosis: The French RespiRare((R)) Cohort. Orphanet Journal of Rare Diseases, 8, 161. http://dx.doi.org/10.1186/1750-1172-8-161
[24]	Zhang, X., Wang, L., Lu, A., et al. (2010) Clinical Study of 28 Cases of Paediatric Idiopathic Pulmonary Haemosiderosis. Journal of Tropical Pediatrics, 56, 386-390. http://dx.doi.org/10.1093/tropej/fmq010
[25]	Sant’Anna, C.C., Horta, A.A., Tura, M.T., et al. (2007) [Idiopathic Pulmonary Hemosiderosis Treated with Azathioprine in a Child]. Jornal Brasileiro de Pneumologia, 33, 743-746. http://dx.doi.org/10.1590/S1806-37132007000600020
[26]	Chin, C.I., Kohn, S.L., Keens, T.G., Margetis, M.F. and Kato, R.M. (2015) A Physician Survey Reveals Differences in Management of Idiopathic Pulmonary Hemosiderosis. Orphanet Journal of Rare Diseases, 10, 98. http://dx.doi.org/10.1186/s13023-015-0319-5

Full-Text