LUNG, vol.184, no.5, pp.297-300, 2006 (SCI-Expanded)
A 15-year-old male had a history of increasing dyspnea on exertion, cough, sputum production, fever, weakness, hemoptysis, and diarrhea. Chest radiography demonstrated bilateral alveolar consolidation. Bronchoalveolar lavage fluid analysis revealed extensive hemosiderin-laden alveolar macrophages. On the basis of iron deficiency anemia, diarrhea, raised antigliadin and antiendomysial antibodies, widespread villous atrophy, and crypt hyperplasia on intestinal biopsy, celiac disease was diagnosed. After treatment with a gluten-free diet, all his clinical symptoms and radiographic findings improved within two weeks. Pulmonary hemosiderosis may occur either as a primary disease of the lungs or as a secondary complication of a cardiac condition or systemic vascular disease. Among adults, certain systemic disorders may be associated with pulmonary hemosiderosis, but in the case of children it is hard to find a specific cause [13, 14]. Reports of an association between pulmonary hemosiderosis and celiac disease are extremely rare. This association has generally been made in children. We here report the case of a young adult for whom pulmonary hemosiderosis was associated with celiac disease. According to our knowledge this is the 16th similar case that has been published over the last 30 years, and in only six of these cases, disease onset occurred after the patient had reached at the age of 15 [1, 6, 8-12].