Cortisone Treatment of Idiopathic Pulmonary Hemosiderosis

A case of idiopathic pulmonary hemosiderosis is reported. The diagnosis was confirmed by the demonstration of typical hemosiderin‐laden macrophages in gastric washings. The pathogenesis is discussed, and the theory that iph is an immuno‐allergic disease with the lungs as the shock organ is accepted as a working hypothesis. The previous good results with splenectomy are mentioned. In this case treatment with cortisone brought on a period during which the patient's condition was improving, and she remained well on a small maintenance dose for 9 months. At that time she had a new attack, but less severe than the previous attacks, and she recovered without transfusions. The experience with hormone therapy in this case has been promising and warrants further trials, maybe in combination with splenectomy. It is suggested that cortisone may prove beneficial for two reasons, (1) blocking an allergen‐antibody reaction, and (2) preventing the pulmonary fibrosis.