IDIOPATHIC pulmonary hemosiderosis is a rare disease affecting children between the ages of a few months and 16 years; only one case has been reported of this disease occurring in an adult.1 In an excellent review of the literature, Wyllie, Sheldon, Bodian and Barlow2 collected 17 previously-reported cases and added an additional 7 cases from the Hospital for Sick Children, London. It is interesting to note that only 4 cases have been reported from the North American continent.3
The clinical picture consists of recurrent attacks of fatigue, cyanosis, fever, pallor, and increasing dyspnea which usually occur suddenly and are associated with a marked degree of iron-deficiency anemia with some features suggesting hemolysis; true intravascular hemolysis does not, however, occur.2 Coughing and vomiting are often prominent symptoms in the acute attacks, hemoptysis and hematemesis have been reported in many cases, and tests for occult blood in the