A 49-year-old man with ischemic cardiomyopathy and persistent hemoptysis for eighteen months.

Abstract

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of recurrent episodes of diffuse alveolar hemorrhage (DAH). IPH commonly manifests with hemoptysis, radiologic chest infiltrates and anemia. The etiology of IPH is unknown, but an immunologic mechanism is widely speculated. The definitive diagnosis of IPH requires a thorough exclusion of other causes of DAH, such as infections, inflammation, malignancy, cardiac diseases, drug and toxin exposure, and medications. Due to the rarity of the disease, a diagnosis is often delayed by years. We present the case of a 49-year-old man with ischemic cardiomyopathy who presented with hemoptysis for eighteen months. Serologic workup was negative for vasculitides and autoimmune diseases. Bronchoscopy revealed DAH. A surgical lung biopsy showed 'bland pulmonary hemorrhage.' A right heart catheterization ruled out cardiac causes of DAH. The patient was diagnosed with IPH and started on systemic corticosteroids with rapid improvement of hemoptysis.

• Authors: Alexis Aiman, Santu Saha, Woon H Chong, Biplab K Saha
• Journal: The American journal of the medical sciences (Am J Med Sci) Vol. 364 Issue 1 Pg. 111-117 (07 2022) ISSN: 1538-2990 [Electronic] United States
• PMID: 35276072 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: Copyright © 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Topics

• Cardiomyopathies
• Hemoptysis (diagnosis, etiology)
• Hemorrhage (complications)
• Hemosiderosis (diagnosis)
• Humans
• Lung Diseases (diagnosis)
• Male
• Middle Aged
• Myocardial Ischemia