Idiopathic pulmonary haemosiderosis misdiagnosed as haemolytic anaemia: a case report

Abstract

Idiopathic pulmonary haemosiderosis is a rare disease primarily affecting children. The condition is characterized by widespread bleeding from alveolar capillaries, resulting in symptoms such as haemoptysis, shortness of breath and iron deficiency anaemia. However, it is not a specific disease and sometimes can manifest solely as anaemia, which may be easily overlooked and misdiagnosed. The purpose of this case report was to describe a 1-year-old boy who exhibited haemolytic anaemia as the only symptom of idiopathic pulmonary haemosiderosis, with the intention of offering clinical insights into the precise diagnosis and subsequent management of this rare and easily misdiagnosed disease. Clinicians should keep idiopathic pulmonary haemosiderosis in mind when evaluating children with haemolytic anaemia and promptly initiate testing and treatment to prevent misdiagnosis and improve outcomes.

Keywords: Idiopathic pulmonary haemosiderosis; case report; child; diagnosis; haemolytic anaemia.

Figure 1.

Chest X-rays and computed tomography (CT) of a 1-year-old male that was initially admitted because of experiencing a pallid-yellow face for 1 week and pale red urine on one occasion more than 10 days before admission: (a) the first chest radiograph undertaken during the first hospitalization (between 29 May 2022 and 2 June 2022) showed no significant abnormalities in the heart, lungs or diaphragm; (b) the second chest radiograph undertaken during the second hospitalization (between 27 June 2022 and 29 June 2022) showed increased lung texture in both lungs; (c) the third chest radiograph undertaken during the third hospitalization (between 21 February 2023 and 2 March 2023) showed no significant abnormalities in the heart, lungs or diaphragm and (d) chest CT scan during the third hospitalization (between 21 February 2023 and 2 March 2023) showed diffuse alveolar exudate in both lungs.