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成人特发性肺含铁血黄素沉着症二例误诊分析并文献复习

谭祥兰 梅同华

临床误诊误治2017,Vol.30Issue(11):4-8,5.
临床误诊误治2017,Vol.30Issue(11):4-8,5.DOI:10.3969/j.issn.1002-3429.2017.11.002

成人特发性肺含铁血黄素沉着症二例误诊分析并文献复习

Idiopathic Pulmonary Hemosiderosis in Adult:2 Misdiagnosed Cases Analysis and Literature Review

谭祥兰 1梅同华1

作者信息

  • 1. 400016 重庆,重庆医科大学附属第一医院呼吸与危重症学科
  • 折叠

摘要

Abstract

Objective To investigate clinical features, therapeutic methods, misdiagnosed causes and prevention measures of idiopathic pulmonary hemosiderosis ( IPH) in adult. Methods Clinical data of 2 adult misdiagnosed patients with IPH was retrospectively analyzed, and related literature was also reviewed. Results A elderly female patient was admit-ted for cough and expectoration for 5 years, short breath for 1 year, aggravation for 12 d and hemoptysis for 3 d, and was diag-nosed as having upper respiratory tract infection, pulmonary infection and so on in other hospitals, and the patient was diag-nosed as having chronic obstructive lung disease in acute exacerbation period combined with pulmonary infection by related ex-aminations after admission in our hospital, but the patient 's condition did not improved after corresponding treatment for 1 week. The other patient was admitted for fatigue for 1 month associated by dyspnea and Labored breathing, headaches and fe-ver for 4 d, and was diagnosed as having pulmonary infection combined with iron-deficiency anemia in local hospital, and the patient's condition slightly improved after corresponding treatment, and the patient was diagnosed as having type I respiratory failure and pneumocystis pneumonia ( PCP) by related examinations after admission in our hospital, but the curative effect was poor by experienced anti-infection treatment. Abundant hemosiderin-laden macrophage was found by bronchoalveolar lavage, and secondary pulmonary hemorrhage was disaffirmed after performing related examinations simultaneously, and then adult IPH was confirmed in the 2 patients. Conditions of the 2 patients were improved after corresponding treatments of glucocorticoid and erythrocyte suspension transfusion respectively. Conclusion Clinicians should consider the possibility of IPH when patients have bilateral pulmonary infiltration lesions combined with anemia with whether having hemoptysis or not, and bronchoscopy is valuable in diagnosis.

关键词

含铁血黄素沉着症/成人/误诊/肺疾病,慢性阻塞性/肺炎

Key words

Hemosiderosis/Adult/Misdiagnosis/Pulmonary disease/chronic obstructive/Pneumonia

分类

医药卫生

引用本文复制引用

谭祥兰,梅同华..成人特发性肺含铁血黄素沉着症二例误诊分析并文献复习[J].临床误诊误治,2017,30(11):4-8,5.

临床误诊误治

OACSTPCD

1002-3429

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