Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia

We describe a possible association between pulmonary hemosiderosis (PH) and a history of bronchopulmonary dysplasia (BPD). Both patients were born at 28-week gestation and presented with PH at ages 22 months and 6 years, respectively. Both initially presented with cough and tachypnea, and bronchoalv...

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Main Authors: David Kurahara, Marina Morie, Maya Yamane, Sarah Lam, Wallace Matthews, Keolamau Yee, Kara Yamamoto
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2014/876195
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author David Kurahara
Marina Morie
Maya Yamane
Sarah Lam
Wallace Matthews
Keolamau Yee
Kara Yamamoto
author_facet David Kurahara
Marina Morie
Maya Yamane
Sarah Lam
Wallace Matthews
Keolamau Yee
Kara Yamamoto
author_sort David Kurahara
collection DOAJ
description We describe a possible association between pulmonary hemosiderosis (PH) and a history of bronchopulmonary dysplasia (BPD). Both patients were born at 28-week gestation and presented with PH at ages 22 months and 6 years, respectively. Both initially presented with cough and tachypnea, and bronchoalveolar lavage showed evidence of hemosiderin-laden macrophages. Initial hemoglobin levels were < 4 g/dL and chest radiographs showed diffuse infiltrates that cleared dramatically within days after initiation of intravenous corticosteroids. In the first case, frank pulmonary blood was observed upon initial intubation, prompting the need for high frequency ventilation, immediate corticosteroids, and antibiotics. The mechanical ventilation wean was made possible by the addition of mycophenolate mofetil (MMF) and hydroxychloroquine. Slow tapering off of medications was accomplished over 6 years. These cases represent a possible correlation between prematurity-associated BPD and PH. We present a review of the literature regarding this possible association. In addition, MMF proved to be life-saving in one of the PH cases, as it has been in pulmonary hemorrhage related to systemic lupus erythematosus. Further studies are warranted to investigate the possible association between PH and prematurity-related BPD, as well as the use of MMF in the treatment of PH.
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spelling doaj-art-90603112dfce4e67bbcf3ef226dc602c2025-08-20T03:20:30ZengWileyCase Reports in Pediatrics2090-68032090-68112014-01-01201410.1155/2014/876195876195Pulmonary Hemosiderosis in Children with Bronchopulmonary DysplasiaDavid Kurahara0Marina Morie1Maya Yamane2Sarah Lam3Wallace Matthews4Keolamau Yee5Kara Yamamoto6Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USADepartment of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USADepartment of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USADepartment of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USADepartment of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USADepartment of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USADepartment of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USAWe describe a possible association between pulmonary hemosiderosis (PH) and a history of bronchopulmonary dysplasia (BPD). Both patients were born at 28-week gestation and presented with PH at ages 22 months and 6 years, respectively. Both initially presented with cough and tachypnea, and bronchoalveolar lavage showed evidence of hemosiderin-laden macrophages. Initial hemoglobin levels were < 4 g/dL and chest radiographs showed diffuse infiltrates that cleared dramatically within days after initiation of intravenous corticosteroids. In the first case, frank pulmonary blood was observed upon initial intubation, prompting the need for high frequency ventilation, immediate corticosteroids, and antibiotics. The mechanical ventilation wean was made possible by the addition of mycophenolate mofetil (MMF) and hydroxychloroquine. Slow tapering off of medications was accomplished over 6 years. These cases represent a possible correlation between prematurity-associated BPD and PH. We present a review of the literature regarding this possible association. In addition, MMF proved to be life-saving in one of the PH cases, as it has been in pulmonary hemorrhage related to systemic lupus erythematosus. Further studies are warranted to investigate the possible association between PH and prematurity-related BPD, as well as the use of MMF in the treatment of PH.http://dx.doi.org/10.1155/2014/876195
spellingShingle David Kurahara
Marina Morie
Maya Yamane
Sarah Lam
Wallace Matthews
Keolamau Yee
Kara Yamamoto
Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia
Case Reports in Pediatrics
title Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia
title_full Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia
title_fullStr Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia
title_full_unstemmed Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia
title_short Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia
title_sort pulmonary hemosiderosis in children with bronchopulmonary dysplasia
url http://dx.doi.org/10.1155/2014/876195
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