Skip to main content
Top
Published in: Indian Journal of Pediatrics 1/2019

01-01-2019 | Original Article

Pulmonary Hemorrhage in Children: Etiology, Clinical Profile and Outcome

Authors: Channa de Silva, Aparna Mukherjee, Kana Ram Jat, Rakesh Lodha, Sushil Kumar Kabra

Published in: Indian Journal of Pediatrics | Issue 1/2019

Login to get access

Abstract

Objective

To describe etiology, clinical profile, treatment and outcome of children with pulmonary hemorrhage.

Methods

A chart review of children with pulmonary hemorrhage attending Pediatric Pulmonology services of a tertiary care hospital in North-India was done.

Results

Data of 44 children (mean age 59.2 ± 32.1 mo; 28 boys) were included for the study. Possible idiopathic pulmonary hemosiderosis 16 (36.4%), post infectious complications 11 (25%), immune mediated disorders 8 (18.2%), cardiac and vascular disorders 7 (15.9%), and airway pathologies 2 (4.5%) were the etiologies of pulmonary hemorrhage. Treatment options like medications, bronchial artery embolization and surgical resections were offered according to the etiology. Children with idiopathic pulmonary hemosiderosis and those with immune mediated diseases were treated with systemic steroids and steroid sparing agents; the latter group took longer time to respond and had more relapses.

Conclusions

Identification of main etiological categories of pulmonary hemorrhage in children could be useful to plan investigations and management of wide range of causes in more practical way.
Literature
1.
go back to reference Lazor R. Alveolar haemorrhage syndromes. Eur Respir Mon. 2011;54:15–31. Lazor R. Alveolar haemorrhage syndromes. Eur Respir Mon. 2011;54:15–31.
2.
go back to reference Parris D, van Niekerk A, Jeevarathnum AC, Green RJ. An approach to pulmonary haemorrhage in children. S Afr Respir J. 2017;23:63–70. Parris D, van Niekerk A, Jeevarathnum AC, Green RJ. An approach to pulmonary haemorrhage in children. S Afr Respir J. 2017;23:63–70.
3.
go back to reference Susarla SC, Fan LL. Diffuse alveolar hemorrhage syndromes in children. Curr Opin Pediatr. 2007;19:314–20.CrossRefPubMed Susarla SC, Fan LL. Diffuse alveolar hemorrhage syndromes in children. Curr Opin Pediatr. 2007;19:314–20.CrossRefPubMed
4.
go back to reference Krause ML, Cartin-Ceba R, Specks U, Peikert T. Update on diffuse alveolar hemorrhage and pulmonary vasculitis. Immunol Allergy Clin N Am. 2012;32:587–600.CrossRef Krause ML, Cartin-Ceba R, Specks U, Peikert T. Update on diffuse alveolar hemorrhage and pulmonary vasculitis. Immunol Allergy Clin N Am. 2012;32:587–600.CrossRef
5.
go back to reference de Prost N, Parrot A, Cuquemelle E, et al. Diffuse alveolar hemorrhage in immunocompetent patients: etiologies and prognosis revisited. Respir Med. 2012;106:1021–32.CrossRefPubMed de Prost N, Parrot A, Cuquemelle E, et al. Diffuse alveolar hemorrhage in immunocompetent patients: etiologies and prognosis revisited. Respir Med. 2012;106:1021–32.CrossRefPubMed
7.
go back to reference Kabra SK, Bhargava S, Lodha R, Satyavani A, Walia M. Idiopathic pulmonary hemosiderosis: clinical profile and follow up of 26 children. Indian Pediatr. 2007;44:333–8.PubMed Kabra SK, Bhargava S, Lodha R, Satyavani A, Walia M. Idiopathic pulmonary hemosiderosis: clinical profile and follow up of 26 children. Indian Pediatr. 2007;44:333–8.PubMed
8.
go back to reference Taytard J, Nathan N, de Blic J, et al; French RespiRare® group. New insights into pediatric idiopathic pulmonary hemosiderosis: the French RespiRare® cohort. Orphanet J Rare Dis. 2013;8:161.CrossRefPubMedPubMedCentral Taytard J, Nathan N, de Blic J, et al; French RespiRare® group. New insights into pediatric idiopathic pulmonary hemosiderosis: the French RespiRare® cohort. Orphanet J Rare Dis. 2013;8:161.CrossRefPubMedPubMedCentral
9.
go back to reference Zhang X, Wang L, Lu A, Zhang M. Clinical study of 28 cases of paediatric idiopathic pulmonary haemosiderosis. J Trop Pediatr. 2010;56:386–90.CrossRefPubMed Zhang X, Wang L, Lu A, Zhang M. Clinical study of 28 cases of paediatric idiopathic pulmonary haemosiderosis. J Trop Pediatr. 2010;56:386–90.CrossRefPubMed
10.
go back to reference Quadrelli S, Dubinsky D, Solis M, et al. Immune diffuse alveolar hemorrhage: clinical presentation and outcome. Respir Med. 2017;129:59–62.CrossRefPubMed Quadrelli S, Dubinsky D, Solis M, et al. Immune diffuse alveolar hemorrhage: clinical presentation and outcome. Respir Med. 2017;129:59–62.CrossRefPubMed
11.
go back to reference Castellazzi L, Patria MF, Frati G, Esposito AA, Esposito S. Idiopathic pulmonary haemosiderosis in paediatric patients: how to make an early diagnosis. Ital J Pediatr. 2016;42:86.CrossRefPubMedPubMedCentral Castellazzi L, Patria MF, Frati G, Esposito AA, Esposito S. Idiopathic pulmonary haemosiderosis in paediatric patients: how to make an early diagnosis. Ital J Pediatr. 2016;42:86.CrossRefPubMedPubMedCentral
12.
go back to reference Singh D, Bhalla AS, Veedu PT, Arora A. Imaging evaluation of hemoptysis in children. Ital J Pediatr. 2013;2:54–64. Singh D, Bhalla AS, Veedu PT, Arora A. Imaging evaluation of hemoptysis in children. Ital J Pediatr. 2013;2:54–64.
13.
go back to reference Chin CIC, Kohn SL, Keens TG, Margetis MF, Kato RM. A physician survey reveals differences in management of idiopathic pulmonary hemosiderosis. Orphanet J Rare Dis. 2015;10:98.CrossRefPubMedPubMedCentral Chin CIC, Kohn SL, Keens TG, Margetis MF, Kato RM. A physician survey reveals differences in management of idiopathic pulmonary hemosiderosis. Orphanet J Rare Dis. 2015;10:98.CrossRefPubMedPubMedCentral
14.
go back to reference Sethi GR, Singhal KK, Puri AS, Mantan M. Benefit of gluten-free diet in idiopathic pulmonary hemosiderosis in association with celiac disease. Pediatr Pulmonol. 2011;46:302–5.CrossRefPubMed Sethi GR, Singhal KK, Puri AS, Mantan M. Benefit of gluten-free diet in idiopathic pulmonary hemosiderosis in association with celiac disease. Pediatr Pulmonol. 2011;46:302–5.CrossRefPubMed
Metadata
Title
Pulmonary Hemorrhage in Children: Etiology, Clinical Profile and Outcome
Authors
Channa de Silva
Aparna Mukherjee
Kana Ram Jat
Rakesh Lodha
Sushil Kumar Kabra
Publication date
01-01-2019
Publisher
Springer India
Published in
Indian Journal of Pediatrics / Issue 1/2019
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-018-2725-x

Other articles of this Issue 1/2019

Indian Journal of Pediatrics 1/2019 Go to the issue