scholarly journals Pulmonary Nocardia infection in child with idiopathic pulmonary hemosiderosis: case report and literature review

2021 ◽  
Author(s):  
Qin Lu ◽  
Feizhou Zhang ◽  
Xiaofen Tao ◽  
Lanfang Tang
Keyword(s):  
Clinical Manifestations ◽  
Corticosteroid Treatment ◽  
Lavage Fluid ◽  
Deficiency Anemia ◽  
Pulmonary Hemosiderosis ◽  
Balf Sample ◽  
Chief Complaints ◽  
Term Administration ◽  
Idiopathic Pulmonary Hemosiderosis

Abstract BackgroundIdiopathic pulmonary hemosiderosis (IPH) encompasses a rare and agnogenic group of diffuse alveolar capillary hemorrhagic diseases. Corticosteroid treatment is the globally preferred therapeutic strategy for IPH. However, its long-term administration can cause immunodeficiency. Nocardia infection often occurs in immunocompromised patients and primarily involves the pleura and lungs. Herein, we describe a case of pediatric pulmonary Nocardia infection complicated by IPH.Case presentationA 7-year-old girl presented with chief complaints of pale complexion persisting for 1 year and a cough for 20 days. Abundant hemosiderin-laden macrophages were detected in the gastric juice during the last hospitalization. Uninterrupted small doses of corticosteroids (1–2 mg/kg/day) were administered to the patient to treat the IPH. After nearly two months of corticosteroids therapy, the children began to cough. Next-generation sequencing of the bronchoalveolar lavage fluid (BALF) sample revealed the presence of Nocardia abscessus (N. abscessus) DNA and confirmed IPH again. Linezolid was administered to treat the N. abscessus infection. She recovered well and was discharged after 18 days of hospitalization. After 1 month of follow-up, her pulmonary lesions exhibited gradual resorption, the iron deficiency anemia had resolved, and the IPH appeared to be well-controlled.ConclusionsThis pediatric case of N. abscessus infection complicated by IPH, including the nonspecific clinical manifestations, time-consuming diagnosis, and timely adjusted treatment, provided considerable clinical experience and enlightenment.

scholarly journals Pulmonary Nocardia infection in a child with idiopathic pulmonary hemosiderosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lu Qin ◽  
Fei-Zhou Zhang ◽  
Tong-Yu Yang ◽  
Xiao-Fen Tao ◽  
Lan-Fang Tang
Keyword(s):  
Next Generation Sequencing ◽  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Poor Response ◽  
Corticosteroid Treatment ◽  
Lavage Fluid ◽  
Next Generation ◽  
Pulmonary Hemosiderosis ◽  
Idiopathic Pulmonary Hemosiderosis ◽  
Generation Sequencing

Abstract Background Idiopathic pulmonary hemosiderosis (IPH) encompasses a rare and agnogenic group of diffuse alveolar capillary hemorrhagic diseases. Corticosteroid treatment is the globally preferred therapeutic strategy for IPH; however, it can cause immunodeficiency. Nocardia infection often occurs in immunocompromised patients and primarily involves the pleura and lungs. Herein, we describe a case of pediatric pulmonary Nocardia infection after the corticosteroid treatment of IPH. Case presentation A 7-year-old girl presented with chief complaints of pale complexion persisting for 1 year and a cough for 20 days. Abundant hemosiderin-laden macrophages were detected in the gastric juice, which supported the diagnosis of IPH. Uninterrupted doses of corticosteroids were administered during the last hospitalization. After nearly 2 months of corticosteroids therapy, the patient began to cough and produce a purulent sputum. Next-generation sequencing of the bronchoalveolar lavage fluid revealed Nocardia abscessus (N. abscessus) DNA. Linezolid was administered with good response, and the patient was discharged after 18 days of hospitalization. Her symptoms and pulmonary lesions had recovered, and the IPH appeared to be well-controlled with low dose of corticosteroids in follow-up. Conclusions Nocardia infection should be considered in the differential diagnoses for IPH patients receiving corticosteroid therapy, especially in patients with poor response to conventional empirical antibiotic therapy. Next-generation sequencing of bronchoalveolar lavage fluid may be used to quickly identify the Nocardia. Sulfonamides or linezolid are effective for pediatric pulmonary Nocardia infection.

scholarly journals 1294 Iron Deficiency Anemia in a Child with Idiopathic Pulmonary Hemosiderosis

2010 ◽  
Vol 68 ◽  
pp. 640-641
Author(s):  
S Corujeira ◽  
R Santos-Silva ◽  
F Ferreira ◽  
C Rego ◽  
A Maia ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Pulmonary Hemosiderosis ◽  
Idiopathic Pulmonary Hemosiderosis

Development of sulfasalazine-associated drug-induced lupus erythematosus in patient with rheumatoid arthritis (clinical case)

2021 ◽  
pp. 26-29
Author(s):  
A. N. Kovshik ◽  
E. P. Kiseleva ◽  
N. G. Klyukvina ◽  
G. V. Lukina
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Drug Induced ◽  
Reliable Diagnosis ◽  
Term Administration ◽  
Lupus Syndrome

Drug-induced lupus syndrome (DLS) is a rare adverse event with a variety of drugs. More than a hundred of drugs are known that can cause the development of DLS, and this list is growing as new drugs appear. Physicians of any specialty can face such complications of therapy and should be aware of this pathology. The article presents an analysis of a clinical case of DLS development against the background of long-term administration of sulfasalazine in a patient with a reliable diagnosis of rheumatoid arthritis, as well as a literature review, which includes data on the prevalence, drug groups, clinical manifestations, diagnosis and treatment of this pathology.

scholarly journals Idiopathic pulmonary hemosiderosis mimicking iron deficiency anemia: a delayed diagnosis?

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Sultan Aydin Koker ◽  
Salih Gözmen ◽  
Yeşim Oymak ◽  
Tuba Hilkay Karapinar ◽  
Demet Can ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Pulmonary Hemorrhage ◽  
Chest Radiographs ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Pulmonary Insufficiency ◽  
Gastric Aspirate ◽  
Pulmonary Hemosiderosis ◽  
Idiopathic Pulmonary Hemosiderosis

Idiopathic pulmonary hemosiderosis (IPH) is an uncommon chronic disorder in children. It is characterized by recurrent pulmonary hemorrhage and may result in hemoptysis and pulmonary insufficiency. The most common hematologic manifestation of IPH is iron deficiency anemia. The etiology of IPH is not known and its diagnosis may be difficult due to the variable clinical courses. The most helpful signs for identifying IPH are iron deficiency anemia and recurrent or chronic cough, hemoptysis, dyspnea, wheezing. We report here 5 pediatric cases of IPH presenting with iron deficiency anemia and without pulmonary symptoms. Mean corpuscular volume was low in all patients; iron was low in 4 out of 5 cases; total iron binding capacity was high in all of them; ferritin was low in 3 patients. At follow up, none of them had responded successfully to the iron therapy. Although they didn’t present with pulmonary symptoms, chest radiographs incidentally revealed diffuse reticulonoduler shadows in all of them. Computed tomography revealed diffuse ground-glass opacities, consolidation, increased density. The diagnosis was confirmed by the detection of hemosiderinladen macrophages in bronchoalveolar lavage fluid and gastric aspirate. If patients with iron deficiency anemia don’t respond to iron therapy, they should be examined for IPH. Chest radiographs should be taken even in absence of pulmonary symptoms. Early diagnosis is important for a timely management of IPH.

Long-term Clinical Follow-up of Adult Idiopathic Pulmonary Hemosiderosis and Celiac Disease

CHEST Journal ◽  
1991 ◽  
Vol 99 (6) ◽  
pp. 1525-1526 ◽  
Author(s):  
Adalberto Pacheco ◽  
Ciro Casanova ◽  
Luis Fogue ◽  
Antonio Sueiro
Keyword(s):  
Celiac Disease ◽  
Pulmonary Hemosiderosis ◽  
Idiopathic Pulmonary Hemosiderosis

scholarly journals Severe Respiratory Distress in a Child with Pulmonary Idiopathic Hemosiderosis Initially Presenting with Iron-Deficiency Anemia

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
A. Potalivo ◽  
L. Finessi ◽  
F. Facondini ◽  
A. Lupo ◽  
C. Andreoni ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Unknown Origin ◽  
Deficiency Anemia ◽  
High Dose ◽  
Rapid Improvement ◽  
Severe Respiratory Distress ◽  
Pulmonary Hemosiderosis ◽  
Discharge From Hospital ◽  
Idiopathic Pulmonary Hemosiderosis

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of alveolar hemorrhage in children but should be considered in children with anemia of unknown origin who develop respiratory complications. It is commonly characterized by the triad of recurrent hemoptysis, diffuse parenchymal infiltrates, and iron-deficiency anemia. Pathogenesis is unclear and diagnosis may be difficult along with a variable clinical course. A 6-year-old boy was admitted to the hospital with a severe iron-deficiency anemia, but he later developed severe acute respiratory failure and hemoptysis requiring intubation and mechanical ventilation. The suspicion of IPH led to the use of immunosuppressive therapy with high dose of corticosteroids with rapid improvement in clinical condition and discharge from hospital.

Long-term prednisone and azathioprine treatment of a patient with idiopathic pulmonary hemosiderosis

1992 ◽  
Vol 13 (3) ◽  
pp. 176-180 ◽  
Author(s):  
Giovanni A. Rossi ◽  
Emma Balzano ◽  
Elena Battistini ◽  
Susanna Oddera ◽  
Patrizia Marchese ◽  
...  
Keyword(s):  
Pulmonary Hemosiderosis ◽  
Azathioprine Treatment ◽  
Idiopathic Pulmonary Hemosiderosis

scholarly journals THE ROLE OF URSODEOXYCHOLIC ACID IN THE TREATMENT OF CHRONIC VIRAL HEPATITIS

2017 ◽  
pp. 31-35
Author(s):  
R. G. MYAZIN
Keyword(s):  
Viral Hepatitis ◽  
Ursodeoxycholic Acid ◽  
Safety Profile ◽  
Clinical Manifestations ◽  
Chronic Viral Hepatitis ◽  
Good Tolerability ◽  
Effective Prevention ◽  
Term Administration

Along with etiotropic antiviral therapeutic schemes, treatment of chronic viral hepatitis today involves administration of medications that eliminate the clinical manifestations of the disease. In particular, the use of ursodeoxycholic acid (Urdoxa®), with its high safety profile and good tolerability in case of long-term administration, is justified for the effective prevention of cholestasis.

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