{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:47:55Z","timestamp":1791478075785,"version":"4.3.4"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":158,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pulmonology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Idiopathic pulmonary hemosiderosis (IPH) is a rare pediatric disorder characterized by recurrent alveolar hemorrhage leading to iron\u2010deficiency anemia and diffuse pulmonary infiltrates. Its diagnosis is frequently delayed because early manifestations often mimic common respiratory or hematologic conditions. High\u2010dose corticosteroids remain the mainstay of acute management, yet prolonged steroid dependence is associated with significant sequelae. Emerging evidence suggests that B cell\u2013directed therapy, including rituximab, may offer a steroid\u2010sparing alternative in refractory pediatric IPH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Presentation and Intervention<\/jats:title>\n                    <jats:p>We describe an uncommon case of steroid\u2010dependent IPH. Her clinical course was marked by recurrent hypoxemic episodes, diffuse alveolar bleeding, and severe anemia, leading to multiple admissions to intensive care and repeated transfusion requirements. Although she received prolonged therapy with corticosteroids, hydroxychloroquine, and azathioprine, she consistently relapsed whenever steroid doses were reduced. Rituximab was introduced as a steroid\u2010sparing strategy, after which she demonstrated significant clinical improvement and durable remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates the diagnostic challenges of pediatric IPH when early features are incomplete and underscores the potential value of Rituximab as a steroid\u2010sparing option in refractory disease. The patient\u2032s sustained remission following B cell\u2013directed therapy supports its emerging role in IPH, though larger, well\u2010designed studies are needed to better define its long\u2010term safety and optimal use in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crpu\/3383284","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:33:29Z","timestamp":1780983209000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Rituximab as a Steroid\u2010Sparing Therapy in Pediatric Idiopathic Pulmonary Hemosiderosis: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-230X","authenticated-orcid":false,"given":"Abdulrahman","family":"Aldaithan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1839-5668","authenticated-orcid":false,"given":"Mohamed","family":"Shehab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4923-4528","authenticated-orcid":false,"given":"Mohsen","family":"Alajmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0179-1716","authenticated-orcid":false,"given":"Abdulla","family":"Alfraij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-8-161"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2020.106234"},{"key":"e_1_2_12_3_2","first-page":"333","article-title":"Idiopathic Pulmonary Hemosiderosis: Clinical Profile and Follow Up of 26 Children","volume":"44","author":"Kabra S. K.","year":"2007","journal-title":"Indian Pediatrics"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmq010"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0954-6111(98)90188-3"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/267857"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-024-03267-4"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001813-200211002-00002"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/ph15121549"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01990"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26230"},{"key":"e_1_2_12_12_2","volume-title":"StatPearls. 2025, StatPearls Publishing Copyright 2025","author":"LaFreniere K."}],"container-title":["Case Reports in Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crpu\/3383284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crpu\/3383284","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crpu\/3383284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:33:36Z","timestamp":1780983216000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crpu\/3383284"}},"subtitle":[],"editor":[{"given":"Tun-Chieh","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crpu\/3383284"],"URL":"https:\/\/doi.org\/10.1155\/crpu\/3383284","archive":["Portico"],"relation":{},"ISSN":["2090-6846","2090-6854"],"issn-type":[{"value":"2090-6846","type":"print"},{"value":"2090-6854","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"3383284"}}