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Idiopathic pulmonary hemosiderosis: a review of the treatments used during the past 30 years and future directions

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Abstract

This paper reviews the literature on the treatment modalities for idiopathic pulmonary hemosiderosis (IPH) used over the past 30 years, attempting to define treatment options that appear to be efficacious and safe, and in addition presents a treatment algorithm. IPH is an uncommon etiology of diffuse alveolar hemorrhage. IPH is a rare disease in adults and often associated with a significant temporal delay in diagnosis. Patients present with hemoptysis, radiographic chest abnormalities, and iron deficiency anemia. Although several pathogenetic hypotheses have been proposed, IPH appears to be an immunologic disease, possibly with a genetic component. Corticosteroid therapy represents the first line of treatment, including liposome-incorporated dexamethasone palmitate (liposteroid). Additional immunomodulatory/immunosuppressive medications have been used with varying success, especially in the setting of steroid-refractory disease. Cyclophosphamide, azathioprine, hydroxychloroquine, mycophenolate mofetil, and mesenchymal cell transplantation have been attempted to improve outcome and reduce side effects. Controlled studies are needed to assess the optimal combination of medications, which are effective to control the disease.

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References

  1. Milman N, Pedersen FM (1998) Idiopathic pulmonary haemosiderosis. Epidemiology, pathogenic aspects and diagnosis. Respiratory Medicine 92(7):902–907

    CAS  PubMed  Google Scholar 

  2. Chen X-Y, Sun J-M, Huang X-J (2017) Idiopathic pulmonary hemosiderosis in adults: review of cases reported in the latest 15 years. The Clinical Respiratory Journal 11(6):677–681

    PubMed  Google Scholar 

  3. Miwa S, Imokawa S, Kato M, Ide K, Uchiyama H, Yokomura K, Suda T, Shirai M, Hayakawa H, Chida K (2011) Prognosis in adult patients with idiopathic pulmonary hemosiderosis. Internal Medicine 50(17):1803–1808

    PubMed  Google Scholar 

  4. Ali AM, Milman N, Clausen PP, Reinert P, Pedersen FM, Jacobsen GK (1999) Idiopathic pulmonary haemosiderosis. Favourable effect of oral corticosteroids in two females aged 16 and 55 yrs. European Respiratory Topic 4:53–57

    Google Scholar 

  5. Milman, N. Idiopathic pulmonary hemosiderosis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed Oct 21, 2020.)

  6. Taytard J, Nathan N, de Blic J, Fayon M, Epaud R, Deschildre A, Troussier F, Lubrano M, Chiron R, Reix P, Cros P, Mahloul M, Michon D, Clement A, Corvol H, for the French RespiRare® group (2013) New insights into pediatric idiopathic pulmonary hemosiderosis: the French RespiRare® cohort. Orphanet Journal of Rare Diseases 8:161

    PubMed  PubMed Central  Google Scholar 

  7. Le Clainche L, Le Bourgeois M, Fauroux B, Forenza N, Dommergues JP, Desbois JC et al (2000) Long-term outcome of idiopathic pulmonary hemosiderosis in children. Medicine (Baltimore) 79(5):318–326

    Google Scholar 

  8. Freitas A, Senra V, Marinho A, Guedes M (2015) Chronic alveolar haemorrhage in a paediatric patient: a diagnostic and treatment challenge. BML Case Reports 21:2015

    Google Scholar 

  9. Buckley M, Van Mater H (2020) Idiopathic pulmonary hemosiderosis as a mimic of pulmonary vasculitis: a case report and review of the literature. Current Allergy and Asthma Reports 20(5):13

    PubMed  Google Scholar 

  10. Yanagihara T, Yamamoto Y, Hamada N, Suzuki K, Ogata-Suetsugu S, Harada E, Tagawa T, Fujiwara M, Hashisako M, Fukuoka J, Nakanishi Y (2018) Recurrent idiopathic pulmonary hemosiderosis after long-term remission presented with Sjogren’s syndrome: idiopathic no more? Respiratory Medicine Case Reports 25:68–72

    PubMed  PubMed Central  Google Scholar 

  11. Stainer A, Rice A, Devaraj A, Barnett JL, Donovan J, Kokosi M, Nicholson AG, Cairns T, Wells AU, Renzoni EA (2019) Diffuse alveolar haemorrhage associated with subsequent development of ANCA positivity and emphysema in three young adults. BMC Pulmonary Medicine 19(1):185

    PubMed  PubMed Central  Google Scholar 

  12. Ross B, Halloran K, Adam B, Laing B, Hirji A (2020) Disease recurrence after lung transplantation for idiopathic pulmonary hemosiderosis. Respiratory Medicine Case Reports 30:101128

    PubMed  PubMed Central  Google Scholar 

  13. Wroblewski BM, Stefanovic CR, McDonough VM, Kidik PJ (1997) The challenges of idiopathic pulmonary hemosiderosis and lung transplantation. Critical Care Nurse 17(3):39–44

    CAS  PubMed  Google Scholar 

  14. Calabrese F, Giacometti C, Rea F, Loy M, Sartori F, Di Vittorio G et al (2002) Recurrence of idiopathic pulmonary hemosiderosis in a young adult patient after bilateral single-lung transplantation. Transplantation. 74(11):1643–1645

    PubMed  Google Scholar 

  15. Bavry AA, Knoper S, Alpert JS (2000) Segmental wall motion abnormalities in an individual with idiopathic pulmonary hemosiderosis. CRD. 93(3):201–204

    CAS  Google Scholar 

  16. Sethi GR, Singhal KK, Puri AS, Mantan M (2011) Benefit of gluten-free diet in idiopathic pulmonary hemosiderosis in association with celiac disease. Pediatric Pulmonology 46(3):302–305

    PubMed  Google Scholar 

  17. Khemiri M, Ouederni M, Khaldi F, Barsaoui S (2008) Screening for celiac disease in idiopathic pulmonary hemosiderosis. Gastroentérologie Clinique et Biologique 32(8–9):745–748

    CAS  PubMed  Google Scholar 

  18. Alimi A, Taytard J, Abou Taam R, Houdouin V, Forgeron A, Lubrano Lavadera M et al (2018) Pulmonary hemosiderosis in children with Down syndrome: a national experience. Orphanet Journal of Rare Diseases 13(1):60

    PubMed  PubMed Central  Google Scholar 

  19. Watanabe H, Ayusawa M, Kato M, Chou A, Komori A, Abe Y, Matsumura M, Kamiyama H, Izumi H, Takahashi S (2015) Idiopathic pulmonary hemosiderosis complicated by Down syndrome. Pediatrics International 57(5):1009–1012

    PubMed  Google Scholar 

  20. Oviedo Ramírez MI, Hop K, Carrera E, Soriano Rosas J (2010) Idiopathic pulmonary haemosiderosis in a young adult. Autopsy findings. Archivos de Bronconeumología 46(10):565–567

    PubMed  Google Scholar 

  21. Moissidis I, Chaidaroon D, Vichyanond P, Bahna SL (2005) Milk-induced pulmonary disease in infants (Heiner syndrome). Pediatric Allergy and Immunology 16(6):545–552

    PubMed  Google Scholar 

  22. Torres MJ, Girón MD, Corzo JL, Rodriguez F, Moreno F, Perez E et al (1996) Release of inflammatory mediators after cow’s milk intake in a newborn with idiopathic pulmonary hemosiderosis. The Journal of Allergy and Clinical Immunology 98(6 Pt 1):1120–1123

    CAS  PubMed  Google Scholar 

  23. Dearborn DG, Smith PG, Dahms BB, Allan TM, Sorenson WG, Montana E, Etzel RA (2002) Clinical profile of 30 infants with acute pulmonary hemorrhage in Cleveland. Pediatrics. 110(3):627–637

    PubMed  Google Scholar 

  24. Dearborn DG, Yike I, Sorenson WG, Miller MJ, Etzel RA (1999) Overview of investigations into pulmonary hemorrhage among infants in Cleveland, Ohio. Environmetal Health Perspectives 107(Suppl 3):495–499

    Google Scholar 

  25. Kania A, Misiaszek M, Vašáková M, Szlubowski A, Bugalho A, Pankowski J, Szołkowska M, Roden AC, Celejewska-Wójcik N, Nastałek P, Gnass M, Sładek K (2019) Cryobiopsy in the diagnosis of idiopathic pulmonary hemosiderosis: a case report. Journal of Thoracic Disease 11(7):3195–3201

    PubMed  PubMed Central  Google Scholar 

  26. Kiper N, Göçmen A, Özçelik U, Dilber E, Anadol D (1999) Long-term clinical course of patients with idiopathic pulmonary hemosiderosis (1979–1994): prolonged survival with low-dose corticosteroid therapy. Pediatric Pulmonology 27(3):180–184

    CAS  PubMed  Google Scholar 

  27. Ohga S, Takahashi K, Miyazaki S, Kato H, Ueda K (1995) Idiopathic pulmonary haemosiderosis in Japan: 39 possible cases from a survey questionnaire. European Journal of Pediatrics 154(12):994–995

    CAS  PubMed  Google Scholar 

  28. Chin CIC, Kohn SL, Keens TG, Margetis MF, Kato RM (2015) A physician survey reveals differences in management of idiopathic pulmonary hemosiderosis. Orphanet Journal of Rare Diseases 10:98

    PubMed  PubMed Central  Google Scholar 

  29. Tobler A, Meier R, Seitz M, Dewald B, Baggiolini M, Fey MF (1992) Glucocorticoids downregulate gene expression of GM-CSF, NAP-1/IL-8, and IL-6, but not of M-CSF in human fibroblasts. Blood. 79(1):45–51

    CAS  PubMed  Google Scholar 

  30. Newton R (2000) Molecular mechanisms of glucocorticoid action: what is important? Thorax. 55(7):603–613

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Li Y-T, Guo Y-X, Cai L-M, Pan L, Duan M-Q, Yang L-F et al (2017) Methylprednisolone pulse therapy rescued life-threatening pulmonary hemorrhage due to idiopathic pulmonary hemosiderosis. The American Journal of Emergency Medicine 35(11):1786.e3–1786.e7

    Google Scholar 

  32. Zhang Y, Luo F, Wang N, Song Y, Tao Y (2019) Clinical characteristics and prognosis of idiopathic pulmonary hemosiderosis in pediatric patients. The Journal of International Medical Research 47(1):293–302

    PubMed  Google Scholar 

  33. Colombo JL, Stolz SM (1992) Treatment of life-threatening primary pulmonary hemosiderosis with cyclophosphamide. Chest

  34. Naithani R, Chandra J, Singh V, Kumar V, Dubey NK (2006) Life threatening exacerbation in idiopathic pulmonary hemosiderosis salvaged by cyclophosphamide infusion. The Indian Journal of Chest Diseases & Allied Sciences 48(4):287–289

    Google Scholar 

  35. Helman DL, Sullivan A, Kariya ST, Deering SH, Hueppchen NA, Shorr AF (2003) Management of idiopathic pulmonary haemosiderosis in pregnancy: report of two cases. Respirology. 8(3):398–400

    PubMed  Google Scholar 

  36. Kabra SK, Bhargava S, Lodha R, Satyavani A, Walia M (2007) Idiopathic pulmonary hemosiderosis: clinical profile and follow up of 26 children. Indian Pediatrics 44(5):333–338

    CAS  PubMed  Google Scholar 

  37. Castellazzi, L., Patria, M. F., Frati, G., Esposito, A. A., Esposito, S. (2016). Idiopathic pulmonary haemosiderosis in paediatric patients: how to make an early diagnosis. Italian Journal of Pediatrics [Internet]. [cited 2020 Oct 5];42. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029079/

  38. Pal P, De H, Giri PP, Ganguly N, Mandal A (2019) Early initiation of steroid-sparing drugs in idiopathic pulmonary hemosiderosis. Indian Pediatrics 56(1):73–74

    PubMed  Google Scholar 

  39. Doi T, Ohga S, Ishimura M, Takada H, Ishii K, Ihara K, Nagai H, Hara T (2013) Long-term liposteroid therapy for idiopathic pulmonary hemosiderosis. European Journal of Pediatrics 172(11):1475–1481

    CAS  PubMed  Google Scholar 

  40. Sakamoto R, Matsumoto S, Mitsubuchi H, Nakamura K (2018) Liposteroid and methylprednisolone combination therapy for a case of idiopathic lung hemosiderosis. Respiratory Medicine Case Reports 24:22–24

    PubMed  PubMed Central  Google Scholar 

  41. Mizushima Y, Hamano T, Yokoyama K (1982) Tissue distribution and anti-inflammatory activity of corticosteroids incorporated in lipid emulsion. Annals of the Rheumatic Diseases 41(3):263–267

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Wakiguchi H, Ohga S (2016) Clinical utility of the liposteroid therapy: potential effects on the macrophage activation. Nihon Rinshō Men'eki Gakkai Kaishi 39(3):190–196

    CAS  PubMed  Google Scholar 

  43. Hoshi K, Mizushima Y, Shiokawa Y, Kageyama T, Honma M, Kashiwazaki S, Shichikawa K, Tsunematsu T, Kaneko K (1985) Double-blind study with liposteroid in rheumatoid arthritis. Drugs under Experimental and Clinical Research 11(9):621–626

    CAS  PubMed  Google Scholar 

  44. Doi T, Ohga S, Ishimura M, Takada H, Ishii K, Ihara K, Nagai H, Hara T (2015) Erratum to: long-term liposteroid therapy for idiopathic pulmonary hemosiderosis. European Journal of Pediatrics 174(12):1701–1701

    PubMed  Google Scholar 

  45. Tobai, H., Yano, J., Sato, N., Amanuma, F., Takahashi, M., Endo, M., et al. (2020). Successful liposteroid therapy for a recurrent idiopathic pulmonary hemosiderosis with Down syndrome [Internet]. Vol. 2020, Case Reports in Pediatrics. Hindawi [cited 2020 Aug 15]. p. e5292947. Available from: https://www.hindawi.com/journals/cripe/2020/5292947/

  46. Mushtaq A, Khatoon S, Qureshi MA (2015) Use of corticosteroids in the management of idiopathic pulmonary haemosiderosis: do we have enough evidence. Pakistan Journal of Medical Sciences 31(2):487–489

    PubMed  PubMed Central  Google Scholar 

  47. Hall AG, Tilby MJ (1992) Mechanisms of action of, and modes of resistance to, alkylating agents used in the treatment of haematological malignancies. Blood Reviews 6(3):163–173

    CAS  PubMed  Google Scholar 

  48. Yao T-C, Hung I-J, Wong K-S, Huang J-L, Niu C-K (2003) Idiopathic pulmonary haemosiderosis: an oriental experience. Journal of Paediatrics and Child Health 39(1):27–30

    PubMed  Google Scholar 

  49. Flanagan F, Glackin L, Slattery DM (2013) Successful treatment of idiopathic pulmonary capillaritis with intravenous cyclophosphamide. Pediatric Pulmonology 48(3):303–305

    PubMed  Google Scholar 

  50. de Groot K, Harper L, Jayne DRW, Flores Suarez LF, Gregorini G, Gross WL, Luqmani R, Pusey CD, Rasmussen N, Sinico RA, Tesar V, Vanhille P, Westman K, Savage CO, EUVAS (European Vasculitis Study Group) (2009) Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial. Annals of Internal Medicine 150(10):670–680

    PubMed  Google Scholar 

  51. Harper L, Morgan MD, Walsh M, Hoglund P, Westman K, Flossmann O, Tesar V, Vanhille P, de Groot K, Luqmani R, Flores-Suarez LF, Watts R, Pusey C, Bruchfeld A, Rasmussen N, Blockmans D, Savage CO, Jayne D, EUVAS investigators (2012) Pulse versus daily oral cyclophosphamide for induction of remission in ANCA-associated vasculitis: long-term follow-up. Annals of the Rheumatic Diseases 71(6):955–960

    CAS  PubMed  Google Scholar 

  52. Merkel, P. A., Kaplan, A. A., Falk, R. J. (2020) Granulomatosis with polyangiitis and microscopic polyangiitis: induction and maintenance therapy. In: Appel GB, Fervenza FC, editor. UpToDate. Waltham: UpToDate Inc.

  53. Airaghi L, Ciceri L, Giannini S, Ferrero S, Meroni PL, Tedeschi A (2001) Idiopathic pulmonary hemosiderosis in an adult. Favourable response to azathioprine. Monaldi Archives for Chest Disease 56(3):211–213

    CAS  PubMed  Google Scholar 

  54. Kamienska E, Urasinski T, Gawlikowska-Sroka A, Glura B, Pogorzelski A (2009) Idiopathic pulmonary hemosiderosis in a 9-year-old girl. European Journal of Medical Research 14(Suppl 4):112–115

    PubMed  PubMed Central  Google Scholar 

  55. Butt A, Ahmed R, Sheikh MDA, Khan O, Iqbal N, Rahman AJ et al (2020) Idiopathic pulmonary hemosiderosis - a rare cause of chronic anemia. Monaldi Archives for Chest Disease 90(2)

  56. Saeed MM, Woo MS, MacLaughlin EF, Margetis MF, Keens TG (1999) Prognosis in pediatric idiopathic pulmonary hemosiderosis. Chest. 116(3):721–725

    CAS  PubMed  Google Scholar 

  57. Rossi GA, Balzano E, Battistini E, Oddera S, Marchese P, Acquila M, Fregonese B, Mori PG (1992) Long-term prednisone and azathioprine treatment of a patient with idiopathic pulmonary hemosiderosis. Pediatric Pulmonology 13(3):176–180

    CAS  PubMed  Google Scholar 

  58. Luo X-Q, Ke Z-Y, Huang L-B, Guan X-Q, Zhang X-L, Zhu J, Zhang YC (2008) Maintenance therapy with dose-adjusted 6-mercaptopurine in idiopathic pulmonary hemosiderosis. Pediatric Pulmonology 43(11):1067–1071

    PubMed  Google Scholar 

  59. Lennard L (2002) TPMT in the treatment of Crohn’s disease with azathioprine. Gut. 51(2):143–146

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Ben-Zvi I, Kivity S, Langevitz P, Shoenfeld Y (2012) Hydroxychloroquine: from malaria to autoimmunity. Clinical Reviews in Allergy and Immunology 42(2):145–153

    CAS  PubMed  Google Scholar 

  61. Schrezenmeier E, Dörner T (2020) Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nature Reviews Rheumatology 16(3):155–166

    CAS  PubMed  Google Scholar 

  62. Mackenzie AH (1983) Dose refinements in long-term therapy of rheumatoid arthritis with antimalarials. The American Journal of Medicine 75(1):40–45

    CAS  PubMed  Google Scholar 

  63. Saha, B. K., Bonnier, A., Chong, W. (2020). Antimalarials as antivirals for COVID-19: believe it or not! The American Journal of the Medical Sciences [Internet]. [cited 2020 Oct 26]; Available from: http://www.sciencedirect.com/science/article/pii/S0002962920303712.

  64. Aceti A, Sciutti R, Bracci PR, Bertelli L, Melchionda F, Cazzato S (2012) Idiopathic pulmonary haemosiderosis in a child with Down’s syndrome: case report and review of the literature. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases 29(1):58–61

    CAS  PubMed  Google Scholar 

  65. García-Luzardo M d R, Aguilar-Fernández AJ, Cabrera-Roca G (2010) Idiopathic pulmonary haemosiderosis in childhood: a good response to systemic steroids, inhaled hydroxychloroquine and budesonide. Archivos de Bronconeumología 46(11):612–613

    Google Scholar 

  66. Stone JH, Merkel PA, Spiera R, Seo P, Langford CA, Hoffman GS, Kallenberg CG, St Clair EW, Turkiewicz A, Tchao NK, Webber L, Ding L, Sejismundo LP, Mieras K, Weitzenkamp D, Ikle D, Seyfert-Margolis V, Mueller M, Brunetta P, Allen NB, Fervenza FC, Geetha D, Keogh KA, Kissin EY, Monach PA, Peikert T, Stegeman C, Ytterberg SR, Specks U, RAVE-ITN Research Group (2010) Rituximab versus cyclophosphamide for ANCA-associated vasculitis. The New England Journal of Medicine 363(3):221–232

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Jones RB, Cohen Tervaert JW, Hauser T, Luqmani R, Morgan MD, Peh CA et al (2010) Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. The New England Journal of Medicine 363(3):211–220

    CAS  PubMed  Google Scholar 

  68. van den Brand JAJG, Ruggenenti P, Chianca A, Hofstra JM, Perna A, Ruggiero B, Wetzels JFM, Remuzzi G (2017) Safety of rituximab compared with steroids and cyclophosphamide for idiopathic membranous nephropathy. JASN. 28(9):2729–2737

    PubMed  Google Scholar 

  69. Lopez-Olivo MA, Amezaga Urruela M, McGahan L, Pollono EN, Suarez-Almazor ME (2015) Rituximab for rheumatoid arthritis. Cochrane Database of Systematic Reviews 1:CD007356

    Google Scholar 

  70. Ac A, Em E (1996) Purine metabolism and immunosuppressive effects of mycophenolate mofetil (MMF). Clinical Transplants 10(1 Pt 2):77–84

    Google Scholar 

  71. van Gelder T, Hesselink DA (2015) Mycophenolate revisited. Transplant International 28(5):508–515

    PubMed  Google Scholar 

  72. Xu L-H, Ou R-Q, Wu B-J, Wang H-Y, Fang J-P, Tan W-P (2017) Corticosteroid in combination with leflunomide and mesenchymal stem cells for treatment of pediatric idiopathic pulmonary hemosiderosis. Journal of Tropical Pediatrics 63(5):389–394

    PubMed  Google Scholar 

  73. Wang L-T, Ting C-H, Yen M-L, Liu K-J, Sytwu H-K, Wu KK, Yen BL (2016) Human mesenchymal stem cells (MSCs) for treatment towards immune- and inflammation-mediated diseases: review of current clinical trials. Journal of Biomedical Science 23(1):76

    PubMed  PubMed Central  Google Scholar 

  74. Engela AU, Baan CC, Litjens NHR, Franquesa M, Betjes MGH, Weimar W, Hoogduijn MJ (2013) Mesenchymal stem cells control alloreactive CD8(+) CD28(−) T cells. Clinical and Experimental Immunology 174(3):449–458

    CAS  PubMed  PubMed Central  Google Scholar 

  75. Flowers MED, Martin PJ (2015) How we treat chronic graft-versus-host disease. Blood. 125(4):606–615

    CAS  PubMed  PubMed Central  Google Scholar 

  76. Dulamea A (2015) Mesenchymal stem cells in multiple sclerosis - translation to clinical trials. Journal of Medicine and Life 8(1):24–27

    CAS  PubMed  PubMed Central  Google Scholar 

  77. Dazzi F, Krampera M (2011) Mesenchymal stem cells and autoimmune diseases. Best Practice & Research. Clinical Haematology 24(1):49–57

    CAS  Google Scholar 

  78. Dave M, Mehta K, Luther J, Baruah A, Dietz AB, Faubion WA Jr (2015) Mesenchymal stem cell therapy for inflammatory bowel disease: a systematic review and meta-analysis. Inflammatory Bowel Diseases 21(11):2696–2707

    PubMed  PubMed Central  Google Scholar 

  79. Domínguez-Bendala J, Lanzoni G, Inverardi L, Ricordi C (2012) Concise review: mesenchymal stem cells for diabetes. Stem Cells Translational Medicine 1(1):59–63

    PubMed  Google Scholar 

  80. Matsumoto S, Nakagawa S (2019) Extracorporeal membrane oxygenation for diffuse alveolar hemorrhage caused by idiopathic pulmonary hemosiderosis: a case report and a review of the literature. J Pediatr Intensive Care 8(3):181–186

    PubMed  PubMed Central  Google Scholar 

  81. Gutierrez S, Shaw S, Huseni S, Sachdeva S, Costello JP, Basu S, Nath DS, Klugman D (2014) Extracorporeal life support for a 5-week-old infant with idiopathic pulmonary hemosiderosis. European Journal of Pediatrics 173(12):1573–1576

    PubMed  Google Scholar 

  82. Sun L-C, Tseng Y-R, Huang S-C, Huang P-M, Ko W-J, Lu FL, Wu ET (2006) Extracorporeal membrane oxygenation to rescue profound pulmonary hemorrhage due to idiopathic pulmonary hemosiderosis in a child. Pediatric Pulmonology 41(9):900–903

    PubMed  Google Scholar 

  83. Thornton G, Alotaibi M (2016) 979: idiopathic pulmonary hemosiderosis in adult patients: an epidemiologic analysis. Critical Care Medicine 44(12):321

    Google Scholar 

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  1. Division of Pulmonary and Critical Care Medicine, Ozarks Medical Center, 1100 Kentucky Avenue, West Plains, MO, 65775, USA

    Biplab K. Saha

  2. Department of Clinical Biochemistry, Næstved Hospital, University College Zealand, DK-4700, Næstved, Denmark

    Nils T. Milman

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Saha, B.K., Milman, N.T. Idiopathic pulmonary hemosiderosis: a review of the treatments used during the past 30 years and future directions. Clin Rheumatol 40, 2547–2557 (2021). https://doi.org/10.1007/s10067-020-05507-4

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