Heiner Syndrome Mimicking Pneumonia with Iron Deficiency Anemia

Abstract

Heiner Syndrome is an unusual form of pulmonary hemosiderosis mostly caused by cow milk. It presents as iron deficiency anemi
a,
and hypoproteinemia. This clinical case describes a female infant with failure to thrive presenting with cough, low grade fever , fast
breathing with refusal to feed. On examination severe anemia with congestive cardiac failure was found, the cause of which wa s
evaluated. Chest X ray showed bilateral fluffy infiltrates mimicking pneumonia. Investigations revealed microcytic hypochromic
anemia with normal corrected reticulocyte count. Iron deficiency anemia (IDA) was diagnosed. However, the etiology of bilater al
fluffy lung infiltrates could not be established in this child. Hence Broncho Alveolar Lavage (BAL) for hemosiderin laden
macrophages and immunoglobulin for cow milk precipitin was done to establish the diagnosis.