Blood in sputum, anemia and celiac disease: the doctors in Moscow cured a rare disease in a patient.
A child with hemoptysis and shortness of breath was hospitalized at the National Medical Research Center for Child Health of the Russian Ministry of Health. Blood in sputum appeared mainly in the morning and after exercise. He was also bothered by pain in the hip joints.
For the first time, the disease manifested itself suddenly. Blood in sputum appeared against the background of an increase in temperature and wheezing, heard from a distance. Bronchoscopy at the residence did not reveal the source of the bleeding. After a telemedicine consultation with experts from the Children's Health Center, a planned hospitalization was recommended.
During the examination, iron deficiency anemia was found in the child. According to the results of a chest CT scan, the "airiness" of the lung tissue and the "ground glass" symptom were significantly reduced. These signs made it possible to suspect pulmonary hemosiderosis. Bronchoscopy revealed a significant amount of hemosiderophages in the washing water.
The disease affects the respiratory parts of the lungs. The main features are hemoptysis, iron deficiency anemia and interstitial changes on CT.
Since the boy complained of sharp pain in the left hip joint and lameness after a long walk, he was consulted by a rheumatologist. Tests did not confirm systemic rheumatic disease.
Pulmonary hemosiderosis is often combined with autoimmune pathology, in particular celiac disease. The patient underwent a gastroscopy with biopsy and laboratory tests. They confirmed celiac disease atypically.
This is how doctors identified Lane-Hamilton syndrome. This is a rare disease in which idiopathic pulmonary hemosiderosis is combined with celiac disease. With this syndrome, avoiding gluten can lead to a significant improvement and even to the disappearance of the symptoms. In view of the severity of the condition, the doctors started first-line treatment with prednisolone.