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• W1999849810 abstract "L’hémosidérose pulmonaire idiopathique (HPI) est une pathologie rare chez l’enfant. Son association, à une maladie cœliaque, est encore plus rare et témoigne de son origine immunologique actuellement bien admise. Nous rapportons le cas d’un adolescent de 15 ans admis pour exploration d’hémoptysies récidivantes évoluant depuis deux ans. L’examen physique met en évidence une taille et un poids normaux, une pâleur cutanéomuqueuse en rapport avec une anémie profonde à 4 g/dl. La radiographie thoracique objective un infiltrat alvéolo interstitiel des deux bases pulmonaires : le lavage bronchoalvéolaire trouve un score de Golde à 200. Le diagnostic d’HPI est retenu. La positivité du dosage sérique des anticorps antitransglutaminase tissulaire et antiendomysium a évoqué l’association à une maladie cœliaque malgré l’absence de toute symptomatologie digestive, diagnostic confirmé par la biopsie jéjunale. Initialement, l’évolution sous corticoïdes a été favorable avec une ascension des chiffres d’hémoglobine à 10 g/dl, mais une récidive de l’hémoptysie est survenue deux mois après l’arrêt des corticoïdes. Un régime sans gluten a été institué après confirmation de la maladie cœliaque. Avec un recul d’un an, les hémoptysies n’ont pas récidivé malgré l’arrêt de la corticothérapie. Idiopathic pulmonary haemosiderosis (IPH) is a rare disease in children, and its association with celiac disease is even rarer. Its immunological origin is now well accepted. We report the case of a fifteen-year-old child admitted for evaluation of recurrent hemoptysis that had been evolving over the previous two years. Physical examination of the patient revealed normal weight and height, but there was cutaneous and mucosal pallor due to anemia (haemoglobin 4 g/dl). The chest x-rays showed alveolo-interstitiel infiltrates in both pulmonary bases. Broncho-alveolar lavage resulted in a GOLDE score of 200. The diagnosis of IPH was made. Positive tissue antitransglutaminase and antiendomysin antibodies suggested an association with celiac disease, although there were no digestive symptoms. Finally, this suspected diagnosis was confirmed by jejunal biopsy. A gluten-free diet was initiated after confirmation of the diagnosis. Evolution of the symptoms under corticosteroid therapy was initially favourable, with an increase of hemoglobin to 10 g/dl, but a relapse of hemoptysis occurred two months after the corticosteroid treatment was stopped, but at the twelve-month follow-up there had been no further hemoptysis, even though the corticosteroid had been stopped." @default.
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• W1999849810 date "2007-12-01" @default.
• W1999849810 modified "2023-09-28" @default.
• W1999849810 title "Hémosidérose pulmonaire idiopathique et maladie cœliaque chez l’enfant" @default.
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• W1999849810 doi "https://doi.org/10.1016/j.allerg.2007.08.014" @default.
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