Hemosiderosis medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*There is no [[treatment]] for [[IPH]]; the mainstay of therapy is supportive care based on the [[presentation]] and [[acute]] vs. [[chronic]] nature of the patient. | *There is no gold standrad [[treatment]] for [[IPH]]; the mainstay of therapy is supportive care based on the [[presentation]] and [[acute]] vs. [[chronic]] nature of the patient. | ||
*[[Blood transfusion]] should be done to correct severe [[anemia]] and shock during the [[acute]] phase. | *[[Blood transfusion]] should be done to correct severe [[anemia]] and shock during the [[acute]] phase. | ||
*Patients with [[acute]] [[IPH]] and [[respiratory failure]] [[secondary]] to [[alveolar]] [[hemorrhage]] may require invasive [[ventilation]] support. It is also recommended to consider [[immunosuppressive therapy]] in addition to high [[dose]] systemic [[Corticosteroids|corticosteroids]] in | *Patients with [[acute]] [[IPH]] and [[respiratory failure]] [[secondary]] to [[alveolar]] [[hemorrhage]] may require invasive [[ventilation]] support. | ||
*It is also recommended to consider [[immunosuppressive therapy]] in addition to high [[dose]] systemic [[Corticosteroids|corticosteroids]] in patients with acute IPH and respiratory failure. | |||
*[[Immunosuppressants]] such as [[hydroxychloroquine]], [[azathioprine]], [[cyclophosphamide]], and [[6-mercaptopurine]] are sometimes used in combination with [[steroids]] for severe cases, or when [[steroids]] are [[contraindicated]] or not tolerated, are used. | *[[Immunosuppressants]] such as [[hydroxychloroquine]], [[azathioprine]], [[cyclophosphamide]], and [[6-mercaptopurine]] are sometimes used in combination with [[steroids]] for severe cases, or when [[steroids]] are [[contraindicated]] or not tolerated, are used. | ||
*Other treatment options with unknown [[Efficacy|efficacies]] include [[intravenous immunoglobulin]] ([[IVIG]]), [[plasmapheresis]], liposteroids, and [[dietary]] modification ([[gluten-free diet]] in those with [[celiac disease]] and [[IPH]] has been shown to improve [[symptoms]]). | *Other treatment options with unknown [[Efficacy|efficacies]] include [[intravenous immunoglobulin]] ([[IVIG]]), [[plasmapheresis]], liposteroids, and [[dietary]] modification ([[gluten-free diet]] in those with [[celiac disease]] and [[IPH]] has been shown to improve [[symptoms]]). | ||
Revision as of 08:31, 28 September 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
There is no treatment for IPH; the mainstay of therapy is supportive care based on the presentation and acute vs. chronic nature of the patient. Immuno-suppressants in combination with steroids is used for severe cases. Supportive therapy for IPH includes blood transfusion to correct severe anemia, and invasive ventilation support for respiratory failure secondary to alveolar hemorrhage.
Medical Therapy
- There is no gold standrad treatment for IPH; the mainstay of therapy is supportive care based on the presentation and acute vs. chronic nature of the patient.
- Blood transfusion should be done to correct severe anemia and shock during the acute phase.
- Patients with acute IPH and respiratory failure secondary to alveolar hemorrhage may require invasive ventilation support.
- It is also recommended to consider immunosuppressive therapy in addition to high dose systemic corticosteroids in patients with acute IPH and respiratory failure.
- Immunosuppressants such as hydroxychloroquine, azathioprine, cyclophosphamide, and 6-mercaptopurine are sometimes used in combination with steroids for severe cases, or when steroids are contraindicated or not tolerated, are used.
- Other treatment options with unknown efficacies include intravenous immunoglobulin (IVIG), plasmapheresis, liposteroids, and dietary modification (gluten-free diet in those with celiac disease and IPH has been shown to improve symptoms).