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Year : 2019  |  Volume : 10  |  Issue : 3  |  Page : 170-173

Idiopathic pulmonary hemosiderosis: A differential diagnosis of pulmonary tuberculosis in a young child

Department of Pulmonary Medicine, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India

Correspondence Address:
Dr. Suptish Biswas
Sarada Sarani Road, PO Hridaypur, PS Barasat, Kolkata - 700 127, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/INJMS.INJMS_44_19

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Idiopathic pulmonary hemosiderosis (IPH) is a rare disease diagnosed primarily in children and young adults, characterized by recurrent diffuse alveolar hemorrhage which leads to the deposition of hemosiderin-laden macrophages in the lung. It is a diagnosis of exclusion and requires a high level of clinical suspicion. It may remain undiagnosed for years, hence often mistreated. Here, we describe such a case of IPH in a 15-year-old male who was initially mistreated twice as clinically diagnosed pulmonary tuberculosis first with Category 1 and then Category 2 antitubercular drugs. He had a history of two episodes of hemoptysis, recurrent episodes of paleness, persisting weakness, and shortness of breath. He also had bilateral reticulonodular opacities on chest skiagram. His history raised the suspicion, the presence of hemosiderin-laden macrophages in bronchoalveolar lavage, and transbronchial lung biopsy strongly suggested the diagnosis. However, the final diagnosis came out after ruling out all the probable causes.

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