CDC Study of Acute Pulmonary Hemorrhage/Hemosiderosis in Infants

CDC is planning a study of acute pulmonary hemorrhage/hemosiderosis among infants and would like your help in identifying new cases that occur. Our interest was prompted by a report of a cluster of infants with pulmonary hemosiderosis identified by the pediatric pulmonologists at Rainbow Babies and Childrens Hospital in Cleveland, Ohio (MMWR, Dec. 9, 1994). Another cluster of these cases was also reported by pediatricians in Chicago (MMWR, Feb. 3, 1995). [addendum 1/17/97: Updated reports now available]

In collaboration with interested pediatricians, we plan to undertake a national case-control study of pulmonary hemorrhage/hemosiderosis among infants. For eligibility purposes, the following case definition will be used: pulmonary hemorrhage or pulmonary hemosiderosis or nosebleed in an otherwise healthly infant less than one year of age that is not due to any other known causes of pulmonary hemorrhage in infancy (e.g. cardiac or vascular malformations, infectious processes, trauma). Copies of the case inclusion/exclusion criteria, surveillance report forms, and MMWR articles will be sent to you if you provide your "snail mail" address.

If you have any questions about the proposed study or if you would like to report a case, please let us know. Many thanks!

Ruth A. Etzel, M.D., Ph.D.
Assistant Director for Special Projects
Division of Environmental Hazards and Health Effects
National Center for Environmental Health
4770 Buford Highway, NE
Atlanta, GA 30341-3724

phone: 770-488-7321
FAX: 770-488-7829
beeper: 1-800-582-5365
RAE1@CDC.GOV

Idiopathic Pulmonary Hemorrhage/Hemosiderosis in Infants

Inclusion Criteria:

Pulmonary hemorrhage or pulmonary hemosiderosis or blood draining from the nose or mouth in an otherwise healthy infant less than one year of age that is not due to any other known causes of pulmonary hemorrhage in infancy.

Exclusion Criteria:

Other causes of infant pulmonary hemorrhage:

- bacterial pneumonia

- septicemia

- tuberculosis

- bronchiectasis

- pulmonary malignancy

- Gaucher's disease

- Wegener's granulomatosis

- cardiac abnormalities

- vascular anomalies

ICD-9 codes commonly used to code hospitalizations of infants with pulmonary hemorrhage:

516.1 Idiopathic pulmonary hemorrhage

786.3 Hemoptysis

578.0 Hematemesis

275.0 Dis Iron Metabolism

486 Pneumonia, Organism NOS

518.81 Respiratory Failure

786.09 Respiratory Abnorm NEC

Surveillance Report Form:

Note: Save this page as text to complete and return to the address below

Air Pollution and Respiratory HealthBranch
National Center for Environmental Health
Centers for Disease Control and Prevention
4770 Buford Highway, NE
Mailstop F-39
Atlanta, Georgia 30341-3724
Phone: 770-488-7321
Fax: 770-488-7829

MMWR Articles

Update: Pulmonary Hemorrhage/Hemosiderosis Among Infants - Cleveland, Ohio, 1993-1996. MMWR 2000;49: 180-184. (html full-text)

Acute Pulmonary Hemorrhage/Hemosiderosis Among Infants --- Cleveland, January 1993--November 1994
(December 9, 1994: Vol. 43, No. 48)

Full text (pdf; 197K)

Acute Pulmonary Hemorrhage Among Infants --- Chicago, April 1992--November 1994
(February 3, 1995: Vol. 44, No. 4)

Preview

Full text (pdf; 253K)

See also (addendum 1/17/97):

Update: Pulmonary Hemorrhage/Hemosiderosis Among Infants. (MMWR January 17, 1997: Vol. 46, No. 2.)

Preview

Full text (pdf; 313K)

Other publications (updated 8/30/2002):

Environmental Risk Factors Associated With Pediatric Idiopathic Pulmonary Hemorrhage and Hemosiderosis in a Cleveland Community, by Montaña, E. et al. Pediatrics 1997; 99:e5

Acute Pulmonary Hemorrhage in Infants Associated With Exposure to and Stachybotrysatra Other Fungi. Etzel RA et al. Arch Pediatr Adolesc Med. 1998;152:757-762. [abstract]

Dearborn DG, Smith PG, Dahms BB. Clinical Profile of 30 Infants With Acute Pulmonary Hemorrhage in Cleveland. Pediatrics 2002; 110:627-637. [abstract; full-text for AAP members/subscribers]