Hemoptysis in children: Sometimes scary sometimes petty

Introduction: Hemoptysis is a rare but potentially life-threatening symptom of underlying respiratory tract abnormality in children. It poses a diagnostic challenge as it is difficult to elicit a clear history and perform thorough physical examination in a child. Method: Patients with hemoptysis were reviewed in terms of etiology,treatment and follow-up. Results: In 2009-2014, 3656 patients were followed in pediatric pulmonology department and 66 (1 %) of them were presented with hemoptysis. The mean age was 12,3±4,2 years and 36 (54 %) of them were female. In 12 patients respiratory tract infection, 8 gastrointestinal bleeding, 6 epistacsis, 5 gingivostomatitis, 3 munchausen syndrome, 2 pulmonary arteriovenous malformation, 1 facial arteriovenous malformation, 2 nasopharyngeal mass, 6 miscellaneous diseases were detected. In 18 (27 %) patients the etiology could not been found. The diagnose was made in 9 patients with physical examination, 22 with scopy, 9 with radiological imaging, 3 with angiography.In 3 patients hemoptysis were massive, only 1 patient was died because of massive bleeding during bronchoscopy. All patients were treated for the underlying cause. After treatment, hemoptysis did not repeated. In patients, whom etiology could not been found, hemoptysis had not recurred and they were adolescent. Conclusion: The most common cause of hemoptysis was respiratory tract infection. Then, gastrointestinal bleeding, epistacsis, gingivostomatitis and cough was caused diagnostic confusion in these patients. In 1/3 patients, etiology could not been found and hemoptysis did not recurred after the evaluation. Munchausen syndrome in adolescent girls and munchausen by proxy in infants should be kept in mind.