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Respiratory Medicine Case Reports

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https://www.readbyqxmd.com/read/28337408/eosinophilic-granulomatosis-with-polyangiitis-formerly-known-as-churg-strauss-syndrome-as-a-differential-diagnosis-of-hypereosinophilic-syndromes
#1
Yuri Albuquerque Pessoa Santos, Bruno Rangel Antunes Silva, Pollyanna Natividade Zanconato Barros Assis Lira, Luiz Carlos Aguiar Vaz, Thiago Thomaz Mafort, Leonardo Palermo Bruno, Agnaldo José Lopes
Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare systemic disease situated between primary small vessel vasculitides associated with antineutrophil cytoplasmic antibodies (ANCAs) and hypereosinophilic syndromes (HES). Here, we present a case of EGPA in a 38-year-old male, with a previous diagnosis of asthma, who presented with fever, migratory lung infiltrates and systemic eosinophilia that was refractory to previous courses of antibiotics. This case highlights the importance of the primary care physician understanding the differential diagnosis of pulmonary eosinophilic syndromes...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28337407/fentanyl-induced-chest-wall-rigidity-syndrome-in-a-routine-bronchoscopy
#2
Chee Kiang Phua, Audrey Wee, Albert Lim, John Abisheganaden, Akash Verma
Combination of sedatives such as fentanyl and midazolam during bronchoscopy is recommended by American College of Chest Physician due to its favourable drug profile. It improves patient comfort and tolerance, and is commonly given unless contraindicated. We describe a rare case of fentanyl-induced chest wall rigidity syndrome during a routine bronchoscopy with endobronchial ultrasound guided-transbronchial needle aspiration (EBUS-TBNA) in a 55 year old male presenting with a lung mass and mediastinal lymphadenopathy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28331797/paradoxical-response-with-increased-tumor-necrosis-factor-%C3%AE-levels-to-anti-tuberculosis-treatment-in-a-patient-with-disseminated-tuberculosis
#3
Sho Watanabe, Yugo Kaneko, Hironori Kawamoto, Tomoki Maehara, Yuri Baba, Ikumi Fujisaki, Nayuta Saito, Kai Ryu, Aya Seki, Tsugumi Horikiri, Akira Kinoshita, Hiroshi Takeda, Keisuke Saito, Kazuyosi Kuwano
It has been reported that tuberculosis (TB) worsens after cessation of tumor necrosis factor-α inhibitors and starting anti-TB treatment. Little is known about the immunological pathogenesis of this paradoxical response (PR). We report the first case of a TB patient in whom PR occurred concurrently with elevation of circulating tumor necrosis factor-α (TNFα) levels. A 75-year-old woman, who had been treated with adalimumab for SAPHO syndrome, developed disseminated TB. Soon after administration of anti-TB treatment (isoniazid, rifampicin, pyrazinamide, and ethambutol), and after discontinuation of adalimumab, a PR occurred...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28331796/an-unexpected-finding-in-a-man-with-multiple-pulmonary-nodules-a-pleural-effusion-and-respiratory-failure
#4
Yik Lam Pang, Quentin Jones
We report the case of a 47-year old Caucasian man with a history of depression and high alcohol intake who presented with a one-month history of weight loss, dry cough and abdominal pain. He had no smoking history of note. The patient was treated for a suspected chest infection, however developed respiratory failure and was intubated. A CT showed multiple pulmonary nodules, left pleural thickening extending to the mediastinum and bilateral pleural effusions-larger on the left, suggestive of disseminated malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28331795/pleural-amyloidosis-imitating-pleural-malignancy
#5
Frith Coolbear, Ana-Maria Bilawich, Jonathan Tongson, James Adamo, Andrew Churg
CT chest performed to investigate dyspnea and malaise in an 83 year old man demonstrated bilateral circumferential pleural thickening highly suspicious for pleural mesothelioma or metastatic pleural malignancy. Histopathology of a subsequent pleural biopsy returned a diagnosis of pleural amyloid. This case identifies pleural amyloid as a rare differential consideration for diffuse pleural thickening; the difficulties in distinguishing pleural amyloid from pleural malignancy are highlighted.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28316931/dyspnea-following-intravenous-drug-use
#6
E Matrosovich, R Brodmann, S Lampert, G Lehnert, A Hartmann, J H Ficker
No abstract text is available yet for this article.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#7
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28316929/cytomegalovirus-pneumonitis-complicated-by-a-central-peribronchial-pattern-of-organising-pneumonia
#8
Maria M Cuadrado, Asia Ahmed, Ben Carpenter, Jeremy S Brown
We present five cases of cytomegalovirus (CMV) pneumonitis occurring in patients after recent T cell deplete allogeneic stem cell transplantation (AlloHSCT). These cases were complicated by an organising pneumonia (during the recovery period) with a predominantly central peribronchial pattern. All patients presented with evidence of active CMV pneumonitis which was treated successfully with anti-viral therapy but was followed by persistent severe dyspnoea, cough and hypoxia. High resolution computed tomography (HRCT) imaging showed widespread central peribronchial consolidation with traction bronchiectasis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28316928/double-aortic-arch-diagnosed-in-a-44-year-old-woman-with-recurring-respiratory-infections
#9
Ana Fenández-Tena, Cristina Martínez-González
Complete vascular rings are originated because of the persistence of the fourth aortic arches, which surround the trachea and esophagus partially or completely, compressing them. The most common type of complete vascular ring is the double aortic arch. Symptoms usually appear in the first months of life, and are provoked by esophageal and tracheal compression. The diagnosis is usually made through the chest X-ray and the esophagogram in patients with dysphagia. We present a case in which the diagnosis of a double aortic arch was made in adulthood, suspected through a spirometry test and a chest X-ray...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28289598/massive-hemoptysis-in-a-patient-with-pulmonary-embolism-a-real-therapeutic-conundrum
#10
Yiolanda Herodotou, Andriana I Papaioannou, Anna Karakatsani, Lazaros Reppas, Effrosyni D Manali, Vasiliki Apollonatou, Ioannis Tomos, Elias Brountzos, Spyros Papiris
Massive Hemoptysis and pulmonary embolism are two very severe and potentially fatal pulmonary emergencies requiring completely different treatments. We present the case of a 45-year old male transmitted to our Hospital for massive hemoptysis who at the same time was found to suffer from pulmonary embolism. Hemoptysis was treated with bronchial artery embolization which resulted in cessation of haemorrhage and allowed the administration of anticoagulant therapy a few days later. This case report gives an answer on how to manage a real therapeutic conundrum which is the coexistence of a massive hemoptysis and a concomitant pulmonary embolism...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28275538/analysis-of-significantly-mutated-genes-as-a-clinical-tool-for-the-diagnosis-in-a-case-of-lung-cancer
#11
Yoshihiro Miyashita, Yosuke Hirotsu, Toshiharu Tsutsui, Seishi Higashi, Yusuke Sogami, Yumiko Kakizaki, Taichiro Goto, Kenji Amemiya, Toshio Oyama, Masao Omata
Bronchoendoscopic examination is not necessarily comfortable procedure and limited by its sensitivity, depending on the location and size of the tumor lesion. Patients with a non-diagnostic bronchoendoscopic examination often undergo further invasive examinations. Non-invasive diagnostic tool of lung cancer is desired. A 72-year-old man had a 3.0 cm × 2.5 cm mass lesion in the segment B1 of right lung. Cytological examination of sputum, bronchial washing and curetted samples were all "negative". We could confirm a diagnosis of lung cancer after right upper lung lobe resection pathologically, and also obtained concordant results by genomic analysis using cytological negative samples from airways collected before operation...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28275537/a-histologically-proven-case-of-lymphocytic-interstitial-pneumonia-in-a-hiv-infected-adult-with-an-undetectable-viral-load
#12
Sarah Assaf, Pujan Patel, David Stoeckel
Lymphocytic interstitial pneumonia (LIP) is on the spectrum of lymphoproliferative diseases that can affect the lungs. Although common in human immunodeficiency virus (HIV) infected children, it is rarely reported in adults. A 51-year-old HIV infected female patient presented with worsening dyspnea over five months. She had radiological findings of bilateral lung nodular infiltrates. Her CD4 count was 835 cells/uL and her HIV viral load was undetectable. Bronchoalveolar lavage did not yield any infectious pathogen...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28275536/rheumatoid-arthritis-associated-pulmonary-hypertension-clinical-challenges-reflecting-the-diversity-of-pathophysiology
#13
Evangelia Panagiotidou, Evdokia Sourla, Serafim Xrisovalantis Kotoulas, Sofia Akritidou, Vasileios Bikos, Vasileios Bagalas, Ioannis Stanopoulos, Georgia Pitsiou
The present article reports three clinical cases in order to elucidate the diversity of the pathophysiological mechanisms that underlie rheumatoid arthritis associated pulmonary hypertension. The condition's three major causes are: interstitial lung disease, vasculitis, and chronic thromboembolic disease, but it should be noted that the multiple pulmonary manifestations of rheumatoid arthritis, can all contribute to chronic lung disease or hypoxia. The first patient in this report suffered from moderate restriction due to fibrosis and was diagnosed with pulmonary hypertension during an episode of life threatening hypoxia...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28275535/invasive-pulmonary-aspergillosis-in-a-steroid-dependent-asthmatic
#14
Bibi Aneesah Jaumally, Ahmed M Salem, Ala Eddin Sagar, George Pyrgos
No abstract text is available yet for this article.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28271038/successful-crizotinib-monotherapy-in-egfr-mutant-lung-adenocarcinoma-with-acquired-met-amplification-after-erlotinib-therapy
#15
Katsuhiro Yoshimura, Naoki Inui, Masato Karayama, Yusuke Inoue, Noriyuki Enomoto, Tomoyuki Fujisawa, Yutaro Nakamura, Kengo Takeuchi, Haruhiko Sugimura, Takafumi Suda
MET is a driver oncogene in non-small-cell lung cancer (NSCLC), and its amplification is associated with acquired resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors. A 56-year-old Japanese male with lung adenocarcinoma harboring an EGFR exon 21 L858R mutation received erlotinib to which he responded for 12 months. After disease progression, re-biopsy analyses revealed newly developed MET amplification. Neither EGFR exon 20 T790M mutation nor MET exon 14 mutations were detected...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28239543/endobronchial-neurogenic-tumor-a-combination-of-traumatic-neuroma-and-neurofibroma
#16
Amit Tandon
Traumatic neuromas are uncommon and benign lesions arising from a peripheral nerve injury during surgery. Here we describe a case with histopathologic features of both a traumatic neuroma and neurofibroma in a patient without integumentary physical exam findings nor prior surgical history. A 54 year old male was admitted for surgical debridement of a foot ulcer. During pre-operative evaluation and review of imaging multiple CT scans revealed a stable, 4 mm endobronchial lesion in the left lower lobe. Given history of nicotine abuse, bronchoscopy was performed...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28239542/a-case-of-mixed-dust-pneumoconiosis-with-desquamative-interstitial-pneumonia-like-reaction-in-an-aluminum-welder
#17
Yuki Iijima, Masashi Bando, Hideaki Yamasawa, Hiroshi Moriyama, Tamiko Takemura, Toshiro Niki, Yukihiko Sugiyama
A 60-year-old man presented with an 18-month history of gradually worsening cough and a 12-month history of dyspnea on exertion. High-resolution computed tomography showed bilateral uniform ground grass opacity in the lower lung fields, partially resolved by smoking cessation. A tentative diagnosis of desquamative interstitial pneumonia (DIP) was made. Video-assisted thoracic surgery was performed and pathological analysis showed peribronchiolar fibrosis with intra-alveolar macrophage infiltration. Elemental analysis detected aluminum and iron in the upper lobe and only iron in the lower lobe...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28224078/complications-of-anesthesia-during-electroconvulsive-therapy-due-to-undiagnosed-obstructive-sleep-apnea-a-case-study
#18
Georgia Trakada, Lemonia Velentza, Angeliki Konsta, Athanasia Pataka, Paul Zarogoulidis, Dimitris Dikeos
This is a case description of two patients with bipolar affective disorder, who presented complications, possibly due to underlying, undiagnosed obstructive sleep apnea syndrome (OSAS), during anesthesia for electroconvulsive therapy (ECT). The first patient, just after receiving the second ECT, developed tachypnea with spasm of the upper airways and severe oxygen desaturation He was intubated and transferred to the medical intensive care unit where he was extubated 15 h later. The second patient, just after the eighth ECT, developed tachycardia and severe hypertension...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28224077/electrical-impedance-tomography-and-trans-pulmonary-pressure-measurements-in-a-patient-with-extreme-respiratory-drive
#19
Atsuko Shono, Peter Somhorst, Diederik Gommers
Preserving spontaneous breathing during mechanical ventilation prevents muscle atrophy of the diaphragm, but may lead to ventilator induced lung injury (VILI). We present a case in which monitoring of trans-pulmonary pressure and ventilation distribution using Electrical Impedance Tomography (EIT) provided essential information for preventing VILI.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28217439/egfr-targeted-therapy-in-lung-cancer-an-evolving-story
#20
C Bartholomew, L Eastlake, P Dunn, D Yiannakis
Specific oncogenes with driver mutations, such as the Epidermal Growth Factor Receptor (EGFR 1) gene can lead to non-small-cell lung cancer formation. Identification of these oncogenes, their driver mutations and downstream effects allow the targeting of these pathways by drugs. Such personalised therapy has become an important strategy in combating lung cancer and highlights the need to test for these mutations. Tyrosine Kinase Inhibitors (TKIs) against EGFR, such as Erlotinib, are able to halt these tumour promoting properties in non-small-cell lung cancers...
2017: Respiratory Medicine Case Reports
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