BRONCHOALVEOLAR LAVAGE FINDINGS IN A YOUNG-ADULT WITH IDIOPATHIC PULMONARY HEMOSIDEROSIS AND CELIAC-DISEASE

Idiopathic pulmonary haemosiderosis is a rare disease of unknown autoi mmune aetiology, mainly affecting children and adolescents. A variety of coexisting autoimmune diseases have been described, including coeli ac disease. We describe the case of a man, aged 19 yrs, presenting wit h a one year history of recurrent haemoptysis. Gluten and gliadin anti bodies were positive, and the jejunal biopsy revealed villous atrophy consistent with the diagnosis of coeliac disease. Bronchoalveolar lava ge fluid analysis showed a mean haemosiderin score (Golde index) of 24 0, and a local suppressor/cytotoxic profile on immunocytology. Both cl inical and immunological improvement was obtained after a month of glu ten-free diet, These immunological findings provide new insight into t he pathogenesis of this disease.