Idiopathic pulmonary hemosiderosis

Unilateral sensorineural hearing loss occurred in a 7-year-old girl with idiopathic pulmonary hemosiderosis after she had taken hydroxychloroquine 100 mg bd for 2 years (17). 

There is also a significantly increased incidence of IgA deficiency in patients with autoimmune or potentially autoimmune disorders, and usually it is not clear which came first. It can be argued that autoimmunity is a complication of immune imbalance subsequent to inborn IgA deficiency (H24). With inborn absence of IgA, exposure to normal human colostrum, plasma, and saliva can result in the production of antibodies to IgA. By the time such patients are discovered the etiological mechanisms are often obscured and IgA treatment is out of the question. The incidence of IgA deficiency is known to be 1-4% in the following conditions Still s disease, systemic lupus erythematosus, rheumatoid arthritis, Sjogren s disease, warm hemolytic anemia, megaloblastic anemia, idiopathic pulmonary hemosiderosis, thyrotoxicosis, and cirrhosis. 

Sprecace [5] was the first to suggest an association between gasoline exposure and the pulmonary renal presentation of "idiopathic pulmonary hemosiderosis", more commonly known as Goodpasture s syndrome. Following this observation several cross-sectional [6, 7-14] and case-control [15-29] studies investigating the relation between renal impairment and occupational hydrocarbon exposure have been published. 

Idiopathic pulmonary hemosiderosis Aspirated foreign body Pulmonary trauma or contusion Post-biopsy (transthoracic/transbronchial) Use of anticoagulants/fibrinolytics... 

A type of idiopathic pulmonary hemosiderosis of unknown etiology and pathogenesis is characterized by iron accumulation in the lung, in macrophage, and along collagen fibers. The source of the iron is not known. 

Le Clainche L, Le Bourgeois M, Fauroux B, et al. Long-term outcome of idiopathic pulmonary hemosiderosis in children. Medicine (Baltimore) 2000 79 318-326. 

Donald KJ, Edwards RL, McEvoy JD. Alveolar capillary basement membrane lesions in Goodpasture s syndrome and idiopathic pulmonary hemosiderosis. Am J Med 1975 59(5) 642 9. 

Calabrese F, Giacometti C, Rea F, Loy M, Sartori F, Di Vittorio G, Abudureheman A, Thiene G, Valente M (2002) Recurrence of idiopathic pulmonary hemosiderosis in a young adult patient after bilateral single-lung transplantation. Transplantation 74 1643-1645... 

Wroblewski BM, Stefanovic CR, McDonough VM, Kidik PJ (1997) The challenges of idiopathic pulmonary hemosiderosis and lung transplantation. Crit Care Nurse 17 39-44... 

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