Idiopathic Pulmonary Hemosiderosis in Pediatric in Patients: Report of Four Cases in Rabat, Morrocco

Abstract

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of diffuse alveolar hemorrhage. Patients with IPH usually present with the classical triad: hemoptysis, and iron deficiency anemia, and pulmonary infiltrates on chest imaging, the diagnosis is often delayed by years. We report four IPH pediatrics cases of children diagnosed at the children’s hospital of Rabat, Morocco. The aim of this study is to review the clinical manifestations, diagnostic tools and treatment of this affection. All the four patients were presented with the classical triad, the diagnosis was based on the Clinical, radiologic and biologic findings. Bronchoalveolar lavage was performed to all the patients and confirmed the diagnosis by the identification of siderophages. High doses of Corticosteroids, by an induction therapy with an intravenous methylprednisolone (20 mg/kg/day for 3 days) followed by oral prednisone (1 mg/kg/day) had shown a good therapeutic response. One patient was treated first with oral corticosteroid and switched over to synthetic antimalarial drugs, because he had side effects from long-term cortico therapy. Then the clinical condition has been improved. The evaluation of response to the therapy included the clinical symptoms and signs, laboratory data and chest x ray. The prognosis of IPH is influenced by several factors, including the time of diagnosis, early initiation of treatment, and the presence of comorbidities.