Hemosiderosis Treatment & Management

Updated: Aug 27, 2018
  • Author: Galia D Napchan, MD; Chief Editor: Denise Serebrisky, MD  more...
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Treatment

Medical Care

The treatment of pulmonary hemosiderosis (PH) is directed toward management of the acute crises and long-term therapy.

  • Management of episodes of acute pulmonary hemorrhage includes the following:

    • Oxygen supplementation

    • Blood transfusion to correct severe anemia and shock

      • A study by de Jongh et al recommended screening for hemosiderosis in all patients receiving multiple transfusions. [2]

    • Supportive respiratory therapy for excessive secretions and bronchospasm

    • Mechanical ventilatory support for respiratory failure

    • Extracorporeal membrane oxygenation (proven to be effective after failure of conventional mechanical ventilation)

    • Immunosuppressive therapy

  • Long-term immunosuppressive therapy in hemosiderosis management remains controversial.

  • The main treatment for milk-associated pulmonary hemosiderosis is avoidance of milk and dairy products.

  • Treatment of secondary hemosiderosis is usually directed toward the underlying condition. A gluten-free diet is indicated in cases of celiac disease associated with pulmonary hemosiderosis, even in the absence of GI symptoms. [3]

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Surgical Care

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  • Surgical care is not indicated.

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Consultations

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  • Pediatric pulmonologist

  • Pediatric nephrologist when pulmonary hemosiderosis is associated with abnormal urinalysis findings

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Diet

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  • In patients with Heiner syndrome, the main treatment is avoidance of milk and dairy products.

  • Patients with hemosiderosis associated with celiac disease who are treated with a gluten-free diet show improvement of clinical symptoms and show improvement on radiography findings within 2 weeks. [3]

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Activity

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  • No activity limitation is indicated.

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