Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency.

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Ho-Man Yeung, Lauren Gaffaney
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引用次数: 0

Abstract

Basilar predominant emphysema, or disproportionate emphysematous involvement of the lung bases compared to the apices, is an uncommon radiographic pattern of emphysema traditionally associated with alpha-1-antitrypsin deficiency (AATD). We present a case of a 59-year-old female with 41 pack-year tobacco use, Stage IV COPD with supplemental oxygen, and bibasilar predominant emphysema who successfully underwent bronchoscopic lung volume reduction. She presented with recurrent hospitalizations for frequent exacerbations. After lung reduction, the patient displayed improvement in functional status without hospitalizations at the 15-month follow-up. Careful history taking is essential for any patients diagnosed with lower lobe emphysema to elucidate the underlying etiology. This case challenges the notion that basilar emphysema is sensitive or specific for AATD and emphasizes that this pattern of emphysema has a broad differential diagnosis and alternative etiologies should be considered. Our patient was ultimately diagnosed with smoking-related emphysema, with atypical bibasilar involvement. Furthermore, basilar predominant emphysema should be considered a separate entity from its apical predominant counterpart.

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基底动脉显性肺气肿:超越α -1-抗胰蛋白酶缺乏的思考。
基底占位型肺气肿,或与肺顶端不成比例的肺气肿累及肺底部,是一种罕见的肺气肿影像学表现,传统上与α -1抗胰蛋白酶缺乏症(AATD)相关。我们报告一例59岁女性,吸烟41包年,IV期COPD伴补充氧,双基底动脉显性肺气肿,成功行支气管镜肺减容术。患者因病情频繁恶化而反复住院。肺复位后,患者在15个月的随访中显示功能状态改善,无需住院治疗。对于任何诊断为下肺叶肺气肿的患者,仔细的病史记录是必要的,以阐明潜在的病因。该病例挑战了基底肺气肿对AATD敏感或特异性的观念,并强调这种肺气肿模式具有广泛的鉴别诊断和应考虑其他病因。我们的病人最终被诊断为吸烟相关的肺气肿,非典型双基底动脉受累。此外,基底显性肺气肿应被视为与根尖显性肺气肿不同的个体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Case Reports in Medicine
Case Reports in Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.70
自引率
0.00%
发文量
53
审稿时长
13 weeks
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