Medical Care
The treatment of pulmonary hemosiderosis (PH) is directed toward management of the acute crises and long-term therapy.
-
Management of episodes of acute pulmonary hemorrhage includes the following:
Oxygen supplementation
Blood transfusion to correct severe anemia and shock
A study by de Jongh et al recommended screening for hemosiderosis in all patients receiving multiple transfusions. [2]
Supportive respiratory therapy for excessive secretions and bronchospasm
Mechanical ventilatory support for respiratory failure
Extracorporeal membrane oxygenation (proven to be effective after failure of conventional mechanical ventilation)
Immunosuppressive therapy
-
Long-term immunosuppressive therapy in hemosiderosis management remains controversial.
-
The main treatment for milk-associated pulmonary hemosiderosis is avoidance of milk and dairy products.
-
Treatment of secondary hemosiderosis is usually directed toward the underlying condition. A gluten-free diet is indicated in cases of celiac disease associated with pulmonary hemosiderosis, even in the absence of GI symptoms. [3]
Surgical Care
See the list below:
-
Surgical care is not indicated.
Consultations
See the list below:
-
Pediatric pulmonologist
-
Pediatric nephrologist when pulmonary hemosiderosis is associated with abnormal urinalysis findings
Diet
See the list below:
-
In patients with Heiner syndrome, the main treatment is avoidance of milk and dairy products.
-
Patients with hemosiderosis associated with celiac disease who are treated with a gluten-free diet show improvement of clinical symptoms and show improvement on radiography findings within 2 weeks. [3]
-
Image of a kidney viewed under a microscope. The brown areas contain hemosiderin.
