Hemosiderosis: Symptoms, Causes, and Diagnosis in Lungs, Kidneys


Hemosiderosis is a term used to describe an overload of iron in your organs or tissues. About 70 percent of the iron in your body is found in your red blood cells. When your red blood cells die, they release that iron, which becomes hemosiderin. Hemosiderin is one of the proteins (along with ferritin) that stores iron in your body’s tissue. Excessive accumulation of hemosiderin in tissues causes hemosiderosis.
This condition is different from hemochromatosis, which is an inherited condition that causes you to absorb too much iron from food.
Keep reading to learn more about the symptoms of hemosiderosis and how it affects your lungs and kidneys.

Hemosiderosis often doesn’t cause symptoms. Over time, however, if there is an accumulation of hemosiderin in your organs, you may notice:
  • coughing (with blood, in severe cases)
  • difficulty breathing
  • fatigue
  • shortness of breath, especially when exercising
  • pain throughout the body
  • unexplained weight loss
  • wheezing
  • slow growth in children

Hemosiderosis has two main causes:
  • bleeding within an organ or area of tissue
  • red blood cells breaking down within your bloodstream
Many conditions can cause either of these to happen in different parts of your body.

Hemosiderosis in the lungs

When hemosiderosis involves your lungs, it’s called pulmonary hemosiderosis. It happens when there’s bleeding in your lungs. Your body usually removes most of this blood, but it can leave behind iron deposits.
Sometimes, there’s no clear cause of the bleeding. In this case, it’s called idiopathic pulmonary hemsiderosis. In other cases, it may be due to an underlying condition, including:
  • pulmonary hypertension
  • autoimmune conditions, such as Goodpasture syndrome
  • chronic lung infections

Hemosiderosis in the kidneys

Your kidneys are responsible for filtering you blood. Having repeated blood transfusions can sometimes overwhelm your kidneys, leading to iron deposits. In other cases, your red blood cells can break down and release iron, leading to an accumulation of iron in your kidneys. This type of hemosiderosis is called renal hemosiderosis.
Several other things can overwhelm your kidneys with iron, including
  • dialysis
  • hemolytic anemia
  • paroxysmal nocturnal hemoglobinuria
  • autoimmune conditions, such as Goodpasture syndrome, which can cause both pulmonary and renal hemosiderosis

Hemosiderhosis can be hard to diagnose because it usually doesn’t cause many symptoms. If your doctor suspects you may have it, they’ll likely start with a complete blood count (CBC) test to get a better idea of what’s in your blood. Your blood test may show that you’re low in iron. This is because excess iron is being stored in your organs, rather than circulating in your blood. Depending on your symptoms, they may also check your blood for any antibodies, which could indicate an autoimmune condition.
Based on your blood test results, your doctor may also order a CT scan or MRI scan of your chest or abdomen to check your lungs and kidneys. You may also need to do a lung function test to check for any underlying conditions that could cause bleeding in your lungs. If your doctor still can’t make a diagnosis, you may need a lung biopsy.
Finally, your doctor might have you do a urine test to see if your kidneys are functioning.

Treatment for hemosiderosis depends on the underlying cause, and some cases don’t require treatment.
Depending on the cause, treatment options include:
  • corticosteroids for bleeding in the lungs and autoimmune conditions
  • immunosuppressant medications for autoimmune conditions
  • oxygen therapy for lung conditions
  • anticoagulants and calcium channel blockers for pulmonary hypertension
  • lung transplant

If left untreated, hemosiderosis can eventually cause damage to the affected tissue or organs. Pulmonary hemosiderosis may lead to pulmonary fibrosis. This can cause scarring and stiffness in your lungs, which can make it hard for them to work properly.
When hemosiderosis affects your kidneys, it can eventually lead to kidney failure.
Both of these complications can usually be avoided with early treatment, so it’s important to tell your doctor about any unusual symptoms you notice, especially if you have an underlying condition that can cause hemosiderosis.

Hemosiderosis is a complex condition that doesn’t always have a clear cause. It’s usually discovered while testing for an unrelated condition, since it typically doesn’t cause any symptoms. However, in some cases it can cause a range of symptoms, including fatigue and wheezing. If you notice any of these symptoms, it’s best to check in with your doctor to avoid complications

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