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Screening for celiac disease in idiopathic pulmonary hemosiderosis
M Khemiri1, M Ouederni, F Khaldi
1Department of Pediatric Medicine A, Children's Hospital of Tunis, Bab-Saadoun-Jabbary, Tunis, Tunisia. monia.khemir@rns.tn
Insights
Screening for celiac disease (CD) in children with idiopathic pulmonary hemosiderosis (IPH) revealed a significant link. Three of ten IPH patients had CD, highlighting the need for CD testing in IPH cases.
Area of Science:
- Pediatric Gastroenterology
- Pulmonology
- Autoimmune Diseases
Background:
- Idiopathic pulmonary hemosiderosis (IPH) is a rare condition characterized by recurrent pulmonary hemorrhage.
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- A potential link between IPH and CD has been suggested but requires further investigation.
Purpose of the Study:
- To screen patients diagnosed with idiopathic pulmonary hemosiderosis (IPH) for the presence of celiac disease (CD).
- To investigate the potential etiological relationship between IPH and CD in a pediatric cohort.
Main Methods:
- A retrospective review of 10 pediatric patients diagnosed with IPH between 1976 and 2006.
- Patients underwent serological and histological testing for celiac disease (CD).
Main Results:
- Three out of ten IPH patients (30%) were diagnosed with celiac disease (CD).
- CD diagnosis was confirmed through positive serology and histological findings.
- Combined corticosteroid treatment and a gluten-free diet led to marked improvement in both IPH and CD symptoms.
- One patient experienced a relapse of both IPH and CD symptoms upon discontinuing the gluten-free diet.
Conclusions:
- A significant proportion of children with IPH also have celiac disease (CD).
- These findings support a close etiopathogenic connection between IPH and CD.
- Routine screening for CD is recommended in pediatric patients diagnosed with IPH, particularly those presenting with suggestive gastrointestinal symptoms.
Aim:
The aim of this report was to screen for celiac disease (CD) in patients with idiopathic pulmonary hemosiderosis (IPH).
Patients And Methods:
Patients with IPH treated at the Children's Hospital of Tunis between 1976 and 2006 were reviewed and investigated for CD, using serological and histological tests.
Results:
A total of 10 children (two boys and eight girls) had IPH. The mean age at diagnosis was 3.1 years. Three had digestive symptoms and positive CD serology, which was confirmed by histological data. Clinical and radiological findings improved markedly in all CD patients with corticosteroid treatment combined with a gluten-free diet. Symptoms of IPH and CD both returned in one patient who stopped the gluten-free diet.
Conclusion:
Three of our 10 patients with IPH also had CD. These data illustrate the close etiopathogenic link between IPH and CD, and strongly suggest that CD be looked for in IPH patients, especially in those with symptoms suggestive of CD.
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