Severe Alveolar Hemorrhage - What's in it for the Gastroenterologist?

J Gastrointestin Liver Dis. 2016 Dec;25(4):555-558. doi: 10.15403/jgld.2014.1121.254.cut.


Background: Alveolar hemorrhage is a potentially life-threatening condition which is usually managed by the pulmonologist. When considering its etiology, there is a rare association that sets the disease into the hands of the gastroenterologist.

Case presentation: We report the case of a 48 year-old female who was admitted to the intensive care unit for severe anemia and hemoptysis. On imaging, diffuse pulmonary infiltrates suggestive of alveolar hemorrhage were detected and a diagnosis of pulmonary hemosiderosis was made. She received cortisone therapy and hematologic correction of anemia, with slow recovery. In search of an etiology for the pulmonary hemosiderosis, an extensive workup was done, and celiac disease specific serology was found positive. After confirmation of celiac disease by biopsy, a diagnosis of Lane-Hamilton syndrome was established. The patient was recommended a gluten-free diet and at 6 months follow-up, resolution of anemia and pulmonary infiltrates were observed.

Conclusion: Although the association is rare, celiac disease should be considered in a patient with idiopathic pulmonary hemosiderosis. In our case, severe anemia and alveolar infiltrates markedly improved with glucocorticoids and gluten-free diet.

Publication types

  • Case Reports

MeSH terms

  • Anemia / etiology
  • Biopsy
  • Celiac Disease / complications*
  • Celiac Disease / diagnosis
  • Celiac Disease / diet therapy
  • Diet, Gluten-Free
  • Endoscopy, Gastrointestinal
  • Female
  • Glucocorticoids / therapeutic use
  • Hemoptysis / etiology
  • Hemorrhage / etiology*
  • Hemosiderosis / complications*
  • Hemosiderosis / diagnosis
  • Hemosiderosis / drug therapy
  • Hemosiderosis, Pulmonary
  • Humans
  • Lung Diseases / complications*
  • Lung Diseases / diagnosis
  • Lung Diseases / drug therapy
  • Middle Aged
  • Prednisone / therapeutic use
  • Pulmonary Alveoli / blood supply*
  • Severity of Illness Index
  • Syndrome
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Glucocorticoids
  • Prednisone