Idiopathic Pulmonary Hemorrhage: A Multidisciplinary Approach Involving Radiology, Laboratory Medicine, and Pharmacy

Abstract

Background: Idiopathic pulmonary hemorrhage (IPH) is a rare but clinically significant disorder characterized by recurrent intra-alveolar bleeding without identifiable cause. It predominantly affects children and can lead to severe respiratory compromise and chronic lung damage if not promptly recognized.

Aim: To review the clinical spectrum, diagnostic challenges, and management strategies for IPH, emphasizing a multidisciplinary approach.

Methods: A comprehensive literature-based analysis was conducted, integrating historical perspectives, pathophysiology, epidemiology, diagnostic modalities, and therapeutic interventions.

Results: IPH manifests in acute and chronic phenotypes, including diffuse alveolar hemorrhage and idiopathic pulmonary hemosiderosis. Diagnosis is primarily exclusionary, requiring elimination of vasculitic, autoimmune, infectious, and hematologic causes. Key diagnostic tools include imaging, bronchoalveolar lavage, and occasionally lung biopsy. Management relies on systemic corticosteroids as first-line therapy, with adjunctive immunosuppressants for refractory cases. Despite therapeutic advances, relapse rates remain high, and long-term complications such as pulmonary fibrosis and iron-deficiency anemia are common. Prognosis varies, with early diagnosis and treatment improving survival, while delayed recognition correlates with increased morbidity and mortality.

Conclusion: IPH demands heightened clinical suspicion, especially in pediatric patients with unexplained anemia and recurrent respiratory symptoms. Multidisciplinary collaboration and individualized immunomodulatory therapy are essential to optimize outcomes.