Hemosiderosis Medication

  • Author: Galia D Napchan, MD; Chief Editor: Michael R Bye, MD   more...
 
Updated: Apr 16, 2012
 

Medication Summary

For isolated pulmonary hemosiderosis (IPH), corticosteroids are believed to be useful in the management of the acute alveolar hemorrhage stage. Failure to respond adequately to corticosteroids alone or unacceptable corticosteroid adverse effects may be indications for using other forms of immunosuppression (eg, azathioprine, chloroquine, cyclophosphamide). Published experience with these medications has been very limited and is confined to case reports.[3] Inhaled corticosteroids also have been used, but current reports are insufficient.

Case reports have described the use of other immunosuppressive medications in the long-term management of idiopathic pulmonary hemosiderosis. One report commented on the use of chloroquine in 3 children with idiopathic pulmonary hemosiderosis, with improvement in the course of their disease. Another report mentioned the efficacy of a combination of azathioprine and corticosteroids in abating acute exacerbations of the disease in a child with idiopathic pulmonary hemosiderosis. The long-term efficacy of immunosuppressive therapy is still in doubt.

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Immunosuppressive agents

Class Summary

These agents are used for patients with conditions caused by immune dysregulation and autoimmunity. A lack of knowledge about the pathogenetic mechanisms involved in idiopathic pulmonary hemosiderosis makes the theoretical basis of such therapies unclear.[4]

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Prednisone (Deltasone, Orasone)

 

Immunosuppressant for treatment of autoimmune disorders. May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Stabilizes lysosomal membranes and suppresses lymphocyte and antibody production.

High doses of prednisone or the equivalent dosage of an IV preparation (eg, methylprednisolone) should be used in the management of acute crisis. For IPH, high-dose corticosteroid usage should be continued for at least 7 d after substantial bleeding has subsided, and the dosage should be tapered over several wk. Some children tolerate complete weaning from corticosteroids in this fashion, but other children demonstrate the need for long-term use.

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Contributor Information and Disclosures
Author

Galia D Napchan, MD  Pediatric Pulmonologist, Joe DiMaggio Children's Hospital

Galia D Napchan, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Coauthor(s)

Isaac Talmaciu, MD  Clinical Assistant Professor, Department of Pediatrics, Florida Atlantic University School of Medicine

Isaac Talmaciu, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Thomas Scanlin, MD  Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School

Thomas Scanlin, MD is a member of the following medical societies: American Association for the Advancement of Science, American Society for Biochemistry and Molecular Biology, American Thoracic Society, Society for Pediatric Research, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Charles Callahan, DO  Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, and Christian Medical & Dental Society

Disclosure: Nothing to disclose.

Mary E Cataletto, MD  Director of Children's Sleep Services, Winthrop Sleep Disorders Center; Professor of Clinical Pediatrics, State University of New York at Stony Brook

Mary E Cataletto, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Chest Physicians

Disclosure: Shering Plough Pharmaceuticals Honoraria Consulting

Chief Editor

Michael R Bye, MD  Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

References

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Image of a kidney viewed under a microscope. The brown areas contain hemosiderin.
 
 
 
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