Back to the Diving Board: A Rare Cause of Hemoptysis in a Healthy Female Athlete.

Lane-Hamilton syndrome is a rare association between idiopathic pulmonary hemosiderosis (IPH) and celiac disease that can present with isolated hemoptysis. We describe a case of a previously healthy 15-year-old female who presented with 1 month of intermittent hemoptysis, chest pain, and severe iron deficiency anemia. Physical examination was remarkable for mild conjunctival pallor and livedo reticularis. Extensive laboratory studies were obtained to rule out infectious, rheumatological, and oncological explanations of anemia. A chest radiograph showed an increased density in the left mid-lung and bilateral opacities, and computed tomography showed scattered multifocal ground glass opacities. Bronchoalveolar lavage revealed hemosiderin-laden macrophages consistent with the diagnosis of IPH. Additional workup for IPH revealed elevated celiac titers. Upper endoscopy confirmed the diagnosis of celiac disease, which led to a final diagnosis of Lane-Hamilton syndrome, a rare co-occurrence of IPH and celiac disease. The treatment plan included a course of systemic steroids and a gluten-free diet. Given this known association, workup for IPH should include testing for celiac disease since a gluten-free diet may prevent future occurrences of alveolar hemorrhage.