Adult idiopathic pulmonary haemosiderosis and coeliac disease

Small bowel biopsies were performed in seven patients in whom a diagnosis of idiopathic pulmonary haemosiderosis had been made. Villous atrophy was present in three patients and convoluted villi in one. There was no correlation between gastrointestinal symptoms or routine blood tests and abnormality of the small bowel mucosa. Three of the four patients with abnormal mucosa had HLA B8 antigen and the three patients with villous atrophy responded to gluten withdrawal.