# A Rare Presentation of Late-Onset Idiopathic Pulmonary Hemosiderosis: A Case Report

## TL;DR

This case report describes a rare instance of late-onset idiopathic pulmonary hemosiderosis in a 74-year-old man, successfully treated with steroids.

## Contribution

The novelty lies in the rare late-onset presentation of idiopathic pulmonary hemosiderosis in an elderly patient.

## Key findings

- Late-onset idiopathic pulmonary hemosiderosis was diagnosed in a 74-year-old male.
- Treatment with oral steroids led to complete radiological resolution and no relapse after one year.

## Abstract

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of diffuse alveolar hemorrhage (DAH). It is associated with a high mortality rate and recurrent episodes of widespread alveolar hemorrhage and most commonly affects children. Here, we present a rare occurrence of late-onset idiopathic pulmonary hemosiderosis in a 74-year-old male. He was admitted for non-resolving pneumonia, hemoptysis, and type 1 respiratory failure, along with sideropenic anemia. Chest imaging showed bilateral upper lobe and right middle lobe alveolar opacities. Infective and autoimmune etiologies of diffuse alveolar hemorrhage were ruled out during the evaluation. Transbronchial lung biopsy showed patchy alveolar hemorrhage and abundant hemosiderin pigment deposition, revealing idiopathic pulmonary hemosiderosis. The patient was successfully treated with oral steroids, followed by complete radiological resolution without clinical relapse at one-year follow-up.