A rare case of pulmonary haemosiderosis associated with coeliac disease: Lane Hamilton syndrome
Published Date: 15th September 2021
Publication Authors: Low SE
Introduction
Idiopathic pulmonary haemosiderosis (IPH) is a rare disorder characterised by haemoptysis, diffuse alveolar infiltrates and iron deficiency anaemia. Even rarer is the Lane Hamilton syndrome where IPH is associated with coeliac disease.
Background(s)
A 37 year old woman presented with haemoptysis and breathlessness. Computerised tomography pulmonary angiogram showed multiple areas of ground glass changes and interstitial lung disease was suspected. An autoimmune screen was negative. Pathology: Bronchoalveolar lavage showed plentiful haemosiderin laden macrophages and fresh bleeding. Wedge lung biopsies were also taken and showed similar appearances. There was no vasculitis or background fibrosis. Based on this, a diagnosis of idiopathic pulmonary haemosiderosis was made.
Discussion(s)
On looking at her medical history, we found that the patient had also been diagnosed with coeliac disease (CD) and suggested an overall diagnosis of Lane Hamilton syndrome which was communicated to the physicians. She was started on prednisolone and azathioprine and has improved.
Conclusion(s)
IPH is a rare cause of haemoptysis in children and even less common in adults. When associated with CD, it has been defined as the Lane Hamilton syndrome. Both disorders are believed to be immunologically mediated. IPH is treated with immunosuppression and having a gluten free diet confers a good prognosis, hence awareness of this entity is important. This case also reinforces the importance of a patient's medical history and good clinicopathological correlation.
Low, S; Gosney, J. (2021). A rare case of pulmonary haemosiderosis associated with coeliac disease: Lane Hamilton syndrome. Journal of Pathology. 255 (Suppl S1), S51