Journal Article

Clinical features and risk factors for recurrence of idiopathic pulmonary hemosiderosis in children

Wang, Lili, Zhang, Rui, Liu, Hanmin, Chen, Lina, Li, Yan

2024

Overview

Background This study aims to review the clinical characteristics, therapeutic response and outcome of idiopathic pulmonary hemosiderosis (IPH), and discover the risk factors for recurrence in children with IPH, which will be helpful for the early diagnosis and reasonable treatment of this disease. Methods Children with a diagnosis of IPH were enrolled in the study. Clinical data of the children were collected and analysed. Results A total of 32 patients with regular follow-up after diagnosis were included in this study. Anaemia, cough and haemoptysis constituted the most common initial symptoms of the disease, and the incidences were 90.6%, 75% and 56.2%, respectively. The mean gap between the onset of symptoms and diagnosis was 5 (0.25-36) months. Most of the children experienced remission (complete and partial remission) over the course of 6 months of treatment, but 19 of the children experienced relapse. The causes of disease recurrence included respiratory tract infection (37.5%), corticosteroid (CS) reduction (18.8%), and irregular medication (6.3%). Interestingly, we found that children with history of allergy (HR 4.255, 1.107–16.356) tended to experience disease recurrence ( p  = 0.01). Conclusions Cough and anaemia are the most common symptoms in children with IPH. The recurrence rate of this disease is high, and respiratory tract infection is the most common cause of its recurrence. High-dose CS impluse therapy cannot reduce the recurrence rate of the disease. Allergic history was an import factor associated with disease recurrence. Trial registration This study is a retrospective and observational study, which does not involve human specimens or clinical intervention. Therefore, clinical trial registration is not required, and there is no clinical trial number. However, the study was approved by the Institutional Review Board/Ethics Committee affiliated with West China Second University Hospital, Sichuan University (Ethics review number 2022074).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adrenal Cortex Hormones - therapeutic use / Anemia / Anemia - etiology / Biopsy / Child / Child, Preschool / Children / Children & youth / China - epidemiology / Clinical characteristics / Corticosteroids / Cough / Cough - etiology / Critical Care Medicine / Development and progression / Diagnosis / Disease / Diseases / Dyspnea / Ethics / Female / Hemoglobin / Hemoptysis / Hemoptysis - etiology / Hemosiderosis / Hemosiderosis - complications / Hemosiderosis, Pulmonary / Humans / Idiopathic pulmonary hemosiderosis / Immunology / Infant / Intensive / Internal Medicine / Lavage / Lung Diseases / Male / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Pediatric research / Pediatric respiratory diseases / Pneumology/Respiratory System / Pneumonia / Recurrence / Relapse / Remission / Remission (Medicine) / Respiration / Respiratory tract diseases / Respiratory tract infection / Respiratory Tract Infections - complications / Respiratory Tract Infections - epidemiology / Retrospective Studies / Risk factor / Risk Factors / Steroids