Abstract Objective To investigate the causes, clinical features, therapy and treatment outcomes of recurrent hemoptysis in children and to improve the skills of pediatricians in the etiological diagnosis and treatment of recurrent hemoptysis in children. Methods The clinical, laboratory, and imaging data of 39 children with recurrent hemoptysis between January 1996 and February 2013 were collected to retrospectively analyze the age of onset, etiology, amount of hemoptysis, imaging changes, treatment methods, and follow-up outcomes. Results In the 39 children, including idiopathic pulmonary hemosiderosis (16 cases, 41%), pulmonary vascular malformation (8 cases, 21%), pulmonary arteriovenous fistula (7 cases, 18%), bronchiectasis (3 cases, 8%), pulmonary tuberculosis (2 cases, 5%), pulmonary cystic fibrosis (2 cases, 5%), and lung tumor (1 case, 3%). The contrast-enhanced lung CT scans and pulmonary and bronchial arteriography revealed varying degrees of lung imaging changes in 35 cases. Of all cases, 51% were classified as degree I, 28% as degree Ⅱ, and 21% as degree Ⅲ. All children were treated according to the etiology, with the disease controlled. During 0.5-5 years of follow-up, 3 patients with idiopathic pulmonary hemosiderosis were lost to follow-up, and the other cases did not develop hemoptysis again. Conclusions Idiopathic pulmonary hemosiderosis is the main cause of recurrent hemoptysis in children. Contrast-enhanced lung CT scans and pulmonary and bronchial arteriography are important methods for the etiological diagnosis of recurrent hemoptysis in children. Treatment methods should be selected according to the etiology.
CHEN He-Bin,LU Xiao-Xia,JIANG Kun. Etiology, clinical features, and diagnosis and treatment of recurrent hemoptysis in children[J]. CJCP, 2014, 16(3): 281-284.
CHEN He-Bin,LU Xiao-Xia,JIANG Kun. Etiology, clinical features, and diagnosis and treatment of recurrent hemoptysis in children[J]. CJCP, 2014, 16(3): 281-284.
Madhusudhan KS, Srivastava DN, Gamanagatti S. Multifocal epithelioid hemangioendothelioma presenting with hemoptysis[J]. Indian J Pediatr, 2010, 77(6): 699-700.
[8]
Rodrigues CE, Callado MR, Nobre CA, et al. Wegener's granulomatosis: prevalence of the initial clinical manifestations—report of six cases and review of the literature[J]. Rev Bras Reumatol, 2010, 50(2): 150-164.
[9]
Woo P. Theoretical and practical basis for early aggressive therapy in paediatric autoimmune disorders[J]. Curr Opin Rheumatol, 2009, 21(5): 552-557.
Vrielynck S, Mamou-Mani T, Emond S, et al. Diagnostic value of high-resolution CT in the evalutation of chronic infiltrative lung disease in children[J]. AJR Am J Roentgenol, 2008, 191(3): 914-920．
Chun JY, Morgan R, Belli AM. Radiological management of hemoptysis: a comprehensive review of diagnostic imaging and bronchial arterial embolization[J]. Cardiovasc Intervent Radiol, 2010, 33(2): 240-250.
[16]
Shin JH, Park SJ, Ko GY, et al. Embolotherapy for pulmonary arteriovenous malformations in patients without hereditary hemorrhagic telangiectasia[J]. Korean J Radiol, 2010, 11(3): 312-319.
