Nelson Textbook of Pediatrics 22nd Edition | Diffuse alveolar hemorrhage with accumulation of hemosiderin in alveolar macrophages. Idiopathic pulmonary hemosiderosis (IPH) vs secondary (autoimmune, Goodpasture syndrome (anti-GBM), SLE, granulomatosis with polyangiitis (GPA), IgA vasculitis, mitral stenosis, Heiner syndrome (cow's milk protein hypersensitivity)). Clinical triad: iron deficiency anemia, hemoptysis, diffuse pulmonary infiltrates. Diagnosis: BAL (hemosiderin-laden macrophages >20%), lung biopsy. Treatment: corticosteroids (first-line), immunosuppression (azathioprine, cyclophosphamide, rituximab), avoid triggers (cow's milk).
🌐 paeds.online — Pakistan's Pediatric Platform| Type | Key Features | Treatment |
|---|---|---|
| Idiopathic pulmonary hemosiderosis (IPH) | No identifiable cause, diagnosis of exclusion | Corticosteroids (prednisone 1-2 mg/kg/day), immunosuppression (azathioprine, cyclophosphamide), iron replacement |
| Goodpasture syndrome (anti-GBM) | Anti-GBM antibodies, glomerulonephritis, pulmonary hemorrhage | Corticosteroids, cyclophosphamide, plasmapheresis |
| SLE-associated | ANA, anti-dsDNA, low complement | Corticosteroids, mycophenolate, rituximab, treat SLE |
| Heiner syndrome (cow's milk) | Cow's milk protein hypersensitivity (non-IgE), recurrent pneumonia, FTT, iron deficiency | Eliminate cow's milk protein (dietary restriction) |
| Mitral stenosis | Cardiac murmur, echocardiogram findings | Treat mitral stenosis (surgery) |