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Risk Factors for Recurrent Pulmonary Exacerbation in Idiopathic Pulmonary Hemosiderosis
  • +10
  • Mina Gharibzadeh Hızal,
  • Sanem Eryılmaz Polat,
  • Tugba Ramaslı Gursoy,
  • beste Ozsezen,
  • Dilber Ademhan Tural,
  • Jale Karakaya,
  • Nagehan Emiralioğlu,
  • Sevgi Pekcan,
  • Ayşe Aslan,
  • Ebru Yalcin,
  • Deniz Dogru,
  • ugur ozcelik,
  • Nural Kiper
Mina Gharibzadeh Hızal
hacettepe university
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Sanem Eryılmaz Polat
Hacettepe University
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Tugba Ramaslı Gursoy
Gazi Universitesi Tip Fakultesi
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beste Ozsezen
Hacettepe Universitesi Tip Fakultesi
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Dilber Ademhan Tural
Hacettepe University Faculty of Medicine
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Jale Karakaya
Hacettepe University
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Nagehan Emiralioğlu
Hacettepe University
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Sevgi Pekcan
Meram Medical Faculty
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Ayşe Aslan
Gazi Universitesi Tip Fakultesi
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Ebru Yalcin
Hacettepe University Faculty of Medicine
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Deniz Dogru
Hacettepe University
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ugur ozcelik
Hacettepe University
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Nural Kiper
Hacettepe University
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Abstract

Objectives: To evaluate the risk factors of recurrent pulmonary exacerbation and poor prognosis in children with idiopathic pulmonary hemosiderosis (IPH).  Methods: In this multicenter study, 54 patinets with diagnosis of IPH included. Medical records were retrospectively reviewed from three tertiary care hospitals between 1979 and 2019. Also, current information and the long-term progress of patients was determined by contacting the families by telephone. Results: A total of 54 children were included. The median age of onset of symptoms was 4.5 ± 3.8 years. The median time from onset to diagnosis was 0.9 years ± 2.2. The mean number of recurrent episodes per child in the recurrence-positive group was 3.55 (1-15). Univariate analysis demonstrated that patients presenting with hypoxia or requiring transfusion at the time of presentation had significantly more recurrence episodes (P=0.002). Multivariate analysis showed that the presence of hypoxia at the time of initial presentation was a significant independent predictor of recurrent episodes (P=0.027). The median follow-up was 3.3 ± 4.8 years (0.75 months-27 years). There was a significant relationship between the presence of hypoxia, transfusion history, ANA positivity, and elevated transaminases at the time of initial evaluation and treatment response. Conclusions: The present study provides important information on the clinical course and outcome of pediatric IPH, and substantial information regarding factors that affect recurrent exacerbations and prognosis. Demonstrating of hypoxia as an independent risk factor in recurrence episodes could be guide physicians in the planning of treatment strategies.

Peer review status:ACCEPTED

28 Jun 2020Submitted to Pediatric Pulmonology
29 Jun 2020Submission Checks Completed
29 Jun 2020Assigned to Editor
30 Jun 2020Reviewer(s) Assigned
19 Jul 2020Review(s) Completed, Editorial Evaluation Pending
20 Jul 2020Editorial Decision: Revise Major
11 Sep 20201st Revision Received
12 Sep 2020Submission Checks Completed
12 Sep 2020Assigned to Editor
12 Sep 2020Reviewer(s) Assigned
06 Oct 2020Review(s) Completed, Editorial Evaluation Pending
08 Oct 2020Editorial Decision: Revise Minor
02 Nov 20202nd Revision Received
04 Nov 2020Submission Checks Completed
04 Nov 2020Assigned to Editor
04 Nov 2020Reviewer(s) Assigned
17 Nov 2020Review(s) Completed, Editorial Evaluation Pending
20 Nov 2020Editorial Decision: Accept