Hemosiderosis medical therapy
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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 standard treatment for IPH; However high dose steroids are frequently used to control symptoms, with good results.[1]
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).