[Idiopathic pulmonary hemosiderosis presenting with spontaneous pneumomediastinum]

The association between idiopathic pulmonary hemosiderosis [IPH] and pneumomediastinum is unusual. We report a case of a five year old girl admitted for intense pallor, dyspnea and cervical subcutaneous emphysema. In past record, the patient was treated for an iron deficiency anemia since two years old. Complete blood count showed a severe iron deficiency anemia. Chest radiograph revealed bilateral diffuse alveolar infiltrates and pneumomediastinum. Bronchoalveolar lavage fluid showed numerous siderophages. Control chest radiograph two months after, revealed an interstitial fibrosis. Pneumomediastinum may be secondary to pulmonary fibrosis that complicate an old IPH. The patient had a coexisting celiac disease