IDIOPATHIC PULMONARY HEMOSIDEROSIS IN CHI LDREN - ASSESSMENT OF THE PLACE OF FOOD ALLERGIES, BASED ON A SERIES OF 6 CASES

Pulmonary haemosiderosis in children is usually idiopathic and has a p oor prognosis. It therefore justifies thorough aetiological investigat ion. Six children suffering from so-called idiopathic pulmonary haemos iderosis were submitted to a detailed clinical interview looking for t riggering factors or an atopic predisposition. They were also submitte d to an allergological assessment (skin tests, total serum IgE, specif ic IgE), an immunological assessment (IgA, IgC, IgM, serum complement, antinuclear, antimitochondrial, antismooth-muscle and antigliadin ant ibodies), biopsy of the small intestine and determination of the HLA g roup. This assessment demonstrated an association of idiopathic pulmon ary haemosiderosis and coeliac disease in one case. This patient had r aised IgE and a positive RAST to egg white and gluten. Antigliadin ant ibodies were positive in 4 cases. No case of cow's milk intolerance wa s revealed. The immunological assessment did not reveal any abnormalit ies. In conclusion, food sensitization must be systematically investig ated in children with idiopathic pulmonary haemosiderosis. Ultrastruct ural and immunohistological study of the lung would further our unders tanding of the pathogenesis of this disease.