Pulmonary haemosiderosis in a 13-year-old girl with coeliac disease after 3 months on a gluten-free diet: case report and review of the literature.

A 13-year-old girl with controlled coeliac disease who had been on a gluten-free diet for the past 3 months was admitted with respiratory distress and hypoxia for the past week. Chest radiograph and CT scan showed bilateral widespread alveolar shadowing suggestive of a hypersensitive pneumonitis. There was a dramatic radiological and clinical response to oral corticosteroids. Bronchial lavage was suggestive of recurrent aspiration and histology of a transbronchial biopsy showed pulmonary haemosiderosis. We conclude that pulmonary haemosiderosis may occur in children with coeliac disease who are on a gluten-free diet.