Hemosiderosis is a rare, often fatal, condition in which iron builds up in the lungs. The iron is in the form of hemosiderin, a pigment in blood. Hemosiderosis results from bleeding into the lungs, also known as pulmonary hemorrhage.
This condition usually shows up between the ages of 6 months and 20 years. Blood that leaks out of the capillaries is taken up by scavenger cells in the lung. The breakdown products of the blood irritate the lung and lead to scarring.
Symptoms include: cough, producing blood-tinged sputumrapid breathingwheezing, or shortness of breathairway obstructionacute otitis media, or ear infectionrunny nosestomach upset, diarrhea, vomiting, and abdominal distressfailure to thrive, a condition in which an infant or child does not gain weight and grow normallycyanosis, a blue tinge in the skin coloranemia, a low red blood cell count that causes skin pallor, or palenessfatigueweaknesslethargy, a feeling of excessive tirednessliver disease, such as cirrhosis
Hemosiderosis is often linked with anemia and chronic infections. It may also be caused by problems with the heart or the immune system.
Pulmonary hemosiderosis is more common in children under 10 years old and is equally common in boys and girls. When it begins in adulthood, it is more likely to affect males.
Prevention is based on treating the underlying cause, if one can be found.
Diagnosis begins with a medical history and physical exam. Diagnostic tests may include: blood tests, such as a complete blood count, or CBC, and liver function testschest x-raylung scanliver scanlung biopsypulmonary function testssputum cultureculture of stool sample
An important part of the diagnosis is to rule out known causes of bleeding into the lungs.
If hemosiderosis is not effectively treated, long-term effects from the bleeding and kidney damage can include: glomerulonephritis, or progressive destruction of the filtering system of the kidneyscirrhosis of the liver, a condition of continued scarring and decreased liver functiondiabetesheart diseasecongestive heart failure, a condition in which the heart is not able to pump enough blood to body tissuesdeath
Hemosiderosis is not contagious. If the underlying cause is an infection, that infection may be contagious.
The treatment depends on the cause. Blood transfusions may be needed for blood loss. Supplemental oxygen is given for low levels of oxygen in the blood. Corticosteroids and medications that suppress the immune system are often used. If the cause is sensitivity to cow's milk, a milk-free diet may be recommended.
Side effects depend on the treatment used. Side effects of steroids may include stomach upset, jittery feelings, muscle weakness, bloating, and weight gain.
Pulmonary bleeding can recur from time to time and will need to be evaluated.
This condition is monitored for the rest of the person's life. Any further bleeding in the lungs must be evaluated. The healthcare professional should be told about any new or worsening symptoms. Blood tests, pulmonary function tests, and chest x-rays may also help monitor the course of the disease.
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Current Pediatric Diagnosis and Treatment, Hathaway, Groothuis, Hay, Paisley, 1993.
Illustrated Guide to Diagnostic Tests, Springhouse, 1998.
Harrison's Principles of Internal Medicine, Fauci, 1998.