ABSTRACT

Coexistence of idiopathic pulmonary haemosiderosis and celiac disease (Lane-Hamilton Syndrome): A case of complete remission with a gluten-free diet Idiopathic pulmonary hemosiderosis is a rare disease of unknown etiology usually characterized by recurrent episodes of alveolar hemorrhage, hemoptysis and iron deficiency anemia. Celiac disease is an immune-mediated inflammation of the small intestine caused by sensitivity to dietary gluten and related proteins in genetically sensitive individuals. The coexistence of idiopathic pulmonary hemosiderosis and celiac disease, also known as Lane-Hamilton syndrome, is extremely rare. A 24-year-old man presented with history of recurrent hemoptysis, anemia and widespread ground glass opacities in both lungs on high resolution computed tomography scans. Transbronchial parenchymal biopsy by bronchoscopy revealed pulmonary hemosiderosis. Although he was no gastrointestinal symptoms, IgA antibodies against tissue transglutaminase was positive. Histological findings consistent with gluten enteropthy were found on intestinal biopsy. Since pulmonary function testing including carbon-monoxide diffusing capacity were normal, the patient was put on a gluten-free diet and has had no recurrences of hemoptysis over 2 months follow-up. Hemoglobin at 2 months follow up was normal and radiological findings completely disappeared