Pulmonary Hemorrhage in Children: Etiology, Clinical Profile and Outcome

Indian J Pediatr. 2019 Jan;86(1):7-11. doi: 10.1007/s12098-018-2725-x. Epub 2018 Jun 14.

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.

Keywords: Bronchial artery; Embolization; Hemoptysis; Hemosiderosis; Steroids.

MeSH terms

  • Autoimmune Diseases / complications
  • Autoimmune Diseases / therapy
  • Bronchoscopy
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / therapy
  • Child
  • Child, Preschool
  • Embolization, Therapeutic
  • Female
  • Glucocorticoids / therapeutic use
  • Hemorrhage* / diagnosis
  • Hemorrhage* / etiology
  • Hemorrhage* / therapy
  • Hemosiderosis / complications
  • Hemosiderosis / therapy
  • Hemosiderosis, Pulmonary
  • Humans
  • Infections / complications
  • Infections / therapy
  • Lung Diseases* / complications
  • Lung Diseases* / diagnosis
  • Lung Diseases* / etiology
  • Lung Diseases* / therapy
  • Male
  • Retrospective Studies

Substances

  • Glucocorticoids