Prusakova K.V.1, Ilyina N.A.1,2


1 - Saint-Petersburg children’s municipal multi-specialty clinical center of high medical technology.

2 - I.I. Mechnikov North-Western State Medical University. Saint-Petersburg, Russia.



Heiner's syndrome is a rare disease induced by hypersensitivity to cow's milk proteins (CMP) and char-acterized by a predominant lesion of the lungs. The underlying pathogenic mechanism remains un-clear, but immune complex formation and a cell-mediated response are suspected. Diagnosis of the disease is difficult due to the diversity of the clinical picture, the absence of pathognomonic symptoms and clear paraclinical criteria.

Purpose. To reflect the role of computed tomography and the difficulties of differential diagno-sis of a rare form of diffuse alveolar hemorrhage in the lungs.

Materials and methods. The article presents clinical data and results of radiological exami-nation of a child aged 1 year and 4 months admitted to the hospital with severe hypochromic anemia.

Results. The diagnosis of Heiner's syndrome was suspected in the analysis of clinical manifes-tations, the results of computed tomography, as well as in a retrospective analysis of the archive of x-ray data, and subsequently confirmed by bronchoscopy.

Discussion. Heiner's syndrome is one of the variants of diffuse alveolar hemorrhage in chil-dren, usually accompanied by complaints from the respiratory system (shortness of breath, cough, hemoptysis, etc.). A feature of this clinical observation was the absence of complaints from the respir-atory system. Issues of differential diagnosis of Heiner's syndrome and idiopathic pulmonary hemo-siderosis are discussed, as well as comparison of own results with literature data.

Conclusion. Interpretation of computed tomography data in diffuse alveolar hemorrhage is as-sociated with a large number of errors, so a comprehensive and multidisciplinary approach is needed in diagnosing the source of blood loss in iron deficiency anemia. The absence of complaints from the respiratory system, including shortness of breath and hemoptysis, does not exclude the diagnosis of diffuse alveolar hemorrhage in children.


Keywords: Heiner's syndrome, diffuse alveolar hemorrhage, pulmonary hemosiderosis, computed tomography.



Corresponding author: Ilyina N.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Prusakova K.V., Ilyina N.A. Diffuse alveolar hemorrhage in the lungs in an infant with Heiner's syndrome. REJR 2023; 13(1):143-153. DOI: 10.21569/2222-7415-2023-13-1-143-153.


Received: 28.12.22

Accepted: 22.02.23