Respirology Case ReportsPub Date : 2025-10-02eCollection Date: 2025-10-01DOI: 10.1002/rcr2.70363
Tiffany Lin, Jun Keng Khoo, Ryan Hoy
{"title":"The Case for Autoantibody Screening in Stone Benchtop Workers.","authors":"Tiffany Lin, Jun Keng Khoo, Ryan Hoy","doi":"10.1002/rcr2.70363","DOIUrl":"https://doi.org/10.1002/rcr2.70363","url":null,"abstract":"<p><p>Occupational silica exposure is a recognised cause of respiratory diseases such as silicosis, with increasing evidence linking it to systemic autoimmune diseases. We report a case of a 40-year-old stone benchtop fabricator diagnosed with complicated silicosis through a screening program. He was initially asymptomatic apart from Raynaud's phenomenon but had an elevated antinuclear antibody (ANA) titre. Over time, he developed progressive autoimmune disease with multisystem involvement and respiratory decline. This case highlights the potential for silica exposure to trigger severe autoimmune disease and the importance of proactive autoimmune screening in high-risk occupational groups. ANA positivity in otherwise asymptomatic individuals may signal underlying or future autoimmune disease. Clinicians should maintain a high index of suspicion for autoimmune conditions in workers exposed to silica, as early detection offers the potential to mitigate long-term morbidity through earlier intervention.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70363"},"PeriodicalIF":0.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of Sarcoidosis Subsequent to Temporary Corticosteroid Treatment in a Patient With Rheumatoid Arthritis.","authors":"Tatsuhiro Itami, Motoyasu Kato, Yuki Nakashima, Shunichi Kataoka, Haruki Hirakawa, Ryoko Murashima, Eri Hayashi, Nagisa Yoshihara, Takuo Hayashi, Rei Watanabe, Naoto Tamura, Kazuhisa Takahashi","doi":"10.1002/rcr2.70364","DOIUrl":"https://doi.org/10.1002/rcr2.70364","url":null,"abstract":"<p><p>A 69-year-old Japanese woman was diagnosed with rheumatoid arthritis and treated with tacrolimus because of worsening symptoms of arthritis. Four months after tacrolimus initiation, corticosteroids were administered. Arthritis improved after 4 months of corticosteroid administration, and the corticosteroid treatment was terminated. However, 2 months after corticosteroid treatment cessation, the patient developed mediastinal and hilar lymph node swelling, subcutaneous node swelling, uveitis, and elevated serum sarcoidosis-associated markers. Consequently, the patient was diagnosed with sarcoidosis, characterised by non-serodermal epithelial granuloma cells with positive staining for anti-<i>Propionibacterium acnes</i> antibody. Notably, all symptoms improved without systemic steroid administration. Corticosteroids and tacrolimus can affect CD4+ lymphocyte function and number; in the present case, given the use of temporary corticosteroids, they may have caused immune reconstitution inflammatory syndrome-like pathogenesis, which can result in transient sarcoidosis.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70364"},"PeriodicalIF":0.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2025-10-02eCollection Date: 2025-10-01DOI: 10.1002/rcr2.70356
Byron Leonel Saraguro Ramirez
{"title":"Diffuse Pneumonic Type Lepidic Adenocarcinoma (DP-LPA).","authors":"Byron Leonel Saraguro Ramirez","doi":"10.1002/rcr2.70356","DOIUrl":"https://doi.org/10.1002/rcr2.70356","url":null,"abstract":"<p><p>Lepidic adenocarcinoma is a rare subtype of lung adenocarcinoma that develops from the terminal bronchiolar and acinar epithelia of the lung. Diffuse pneumonic lepidic adenocarcinoma is associated with a poor prognosis. We present the case of a male former smoker with diffuse pneumonic lepidic adenocarcinoma.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70356"},"PeriodicalIF":0.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pulmonary Function Outcomes in Children Undergoing Diaphragmatic Plication After Phrenic Nerve Palsy Secondary to Cardiac Surgery: A 10-Year Case Series.","authors":"Ehsan Aghaei Moghadam, Yousef Vojgani, Mahsa Erfanian Salim, Mohammadreza Mirzaaghayan, Behnaz Sohrabi, Hosein Ghasempour, Mohammadsadegh Talebi Kahdouei","doi":"10.1002/rcr2.70369","DOIUrl":"https://doi.org/10.1002/rcr2.70369","url":null,"abstract":"<p><p>Phrenic nerve injury is a recognised complication of congenital cardiac surgery in children, potentially leading to diaphragmatic paralysis and long-term respiratory dysfunction. Diaphragmatic plication is performed to improve lung mechanics, but its mid-term outcomes remain underexplored. The objective was to assess mid-term pulmonary function in children who underwent diaphragmatic plication for phrenic nerve palsy following congenital heart surgery. This retrospective case series included five children who received left diaphragmatic plication between 2011 and 2021 at a tertiary paediatric centre. Pulmonary function was evaluated using spirometry, plethysmography, and the 6-min walk test (6MWT), and compared to predicted normative values. At a mean follow-up of 5 years, forced volume capacity (FVC), forced expiratory volume (FEV<sub>1</sub>), vital capacity (VC), and total lung capacity (TLC) were significantly lower than predicted (<i>p</i> < 0.05). FEV<sub>1</sub>/FVC, residual volume (RV), and forced residual capacity (FRC) were not significantly different. All patients completed the 6MWT (> 300 m), though post-exercise oxygen saturation declined significantly (<i>p</i> = 0.011). Diaphragmatic plication leads to a restrictive pattern and exercise-induced desaturation despite preserved walking capacity.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70369"},"PeriodicalIF":0.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evan Anderson, Shannon Meyler, Alexa Gallagher, Tina Cardona, Benjamin Ellis, Jennifer Ellis, Michael Holton
{"title":"Letter to the Editor: 'Asbestosis Requiring Lung Transplantation in a Retired Hairdresser: An Occupational Exposure to Comb Through'.","authors":"Evan Anderson, Shannon Meyler, Alexa Gallagher, Tina Cardona, Benjamin Ellis, Jennifer Ellis, Michael Holton","doi":"10.1002/rcr2.70368","DOIUrl":"https://doi.org/10.1002/rcr2.70368","url":null,"abstract":"","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70368"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diffuse Alveolar Haemorrhage Complicated by Pulmonary Metastasis of Cardiac Angiosarcoma and Kasabach-Merritt Syndrome: A Case Report.","authors":"Takuma Ikeda, Satoru Terada, Kazuo Endo","doi":"10.1002/rcr2.70371","DOIUrl":"https://doi.org/10.1002/rcr2.70371","url":null,"abstract":"<p><p>Kasabach-Merritt syndrome (KMS) is a consumptive coagulopathy caused by platelet trapping due to the distinctive endothelial structure of vascular tumours. Cardiac angiosarcoma complicated by KMS is exceedingly rare. We report the case of cardiac angiosarcoma in which diffuse alveolar haemorrhage was caused by both pulmonary metastases and KMS. Invasive mechanical ventilation with high positive end-expiratory pressure (PEEP) temporarily achieved transfusion-independent haemostasis. However, a biopsy could not be performed during this window, and the patient experienced a fatal outcome. In case of cardiac angiosarcoma complicated by KMS, early tissue diagnosis is critical. Strategies to achieve transfusion-independent haemostasis such as high PEEP may create an opportunity for prompt biopsy and facilitate timely initiation of definitive treatment.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70371"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shoichiro Matsumoto, Yuki Takigawa, Ken Sato, Kodai Honda, Mariko Otsuki, Satoko Ido, Mayu Goda, Keisuke Shiraha, Takeru Ichikawa, Suzuka Matsuoka, Jun Nishimura, Hiromi Watanabe, Kenichiro Kudo, Keiichi Fujiwara, Takuo Shibayama
{"title":"Aspirated Soybean Mimicking Endobronchial Tumour Removed With a Cryoprobe.","authors":"Shoichiro Matsumoto, Yuki Takigawa, Ken Sato, Kodai Honda, Mariko Otsuki, Satoko Ido, Mayu Goda, Keisuke Shiraha, Takeru Ichikawa, Suzuka Matsuoka, Jun Nishimura, Hiromi Watanabe, Kenichiro Kudo, Keiichi Fujiwara, Takuo Shibayama","doi":"10.1002/rcr2.70366","DOIUrl":"https://doi.org/10.1002/rcr2.70366","url":null,"abstract":"<p><p>Adult airway foreign bodies are misdiagnosed as endobronchial tumours on imaging. A 77-year-old man with asbestosis presented with a worsening cough. Computed tomography (CT) showed a 12-mm low-attenuation right upper-lobe bronchial lesion with distal bronchiectasis and infiltrates. Magnetic resonance imaging (MRI) suggested a fat-containing tumour (lipoma or hamartoma). Flexible bronchoscopy revealed a yellowish polypoid mass; poor sedation tolerance necessitated rigid bronchoscopy under general anaesthesia. Using a 1.7-mm cryoprobe, the lesion was cryoactivated for 10 s and removed en bloc. It proved to be a foreign body resembling a legume and was later confirmed to be an aspirated soybean from 1 month earlier. The fat and water content of soybeans can yield MRI appearances similar to fatty tumours. Distinguishing tumours from foreign bodies by imaging or bronchoscopy alone is challenging. Cryoprobe extraction is effective for hydrated foreign bodies, and aspiration should be considered in the differential diagnosis of endobronchial tumours.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70366"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidental Finding of Azygous Vein Aneurysm on the Background of Myasthenia Gravis-Is It a Wolf in Sheep's Coat?","authors":"Sugeesha Wickramasinghe, John Howells, Syed Mehdi","doi":"10.1002/rcr2.70367","DOIUrl":"https://doi.org/10.1002/rcr2.70367","url":null,"abstract":"<p><p>Azygous vein aneurysm is an extremely rare clinical manifestation and often an incidental diagnosis. This could be idiopathic or secondary to a sinister pathology causing increasing central venous pressure. There is no definitive treatment guidance available due to its rare nature. Vascular interventions and anticoagulation are suggested in complex situations.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70367"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel Gurieff, Senthuran Shivakumar, Joy Lee, Finlay Macrae, Tracy L Leong
{"title":"Treatment-Refractory Tracheobronchitis in Crohn's Disease: A Rare Pulmonary Manifestation of Inflammatory Bowel Disease.","authors":"Gabriel Gurieff, Senthuran Shivakumar, Joy Lee, Finlay Macrae, Tracy L Leong","doi":"10.1002/rcr2.70359","DOIUrl":"https://doi.org/10.1002/rcr2.70359","url":null,"abstract":"<p><p>Large airway inflammation is a rare and under-recognised pulmonary manifestation of Crohn's disease. It is associated with significant morbidity and occurs independent of intestinal disease activity. Inflammation of the trachea and bronchi in inflammatory bowel diseases is typically responsive to corticosteroids or anti-tumour necrosis factor agents. In this report, we present a case of tracheobronchitis in Crohn's disease presenting with a chronic productive cough while on adalimumab. The diagnosis was made by bronchoscopy, which revealed inflammation of the trachea and main bronchi, with biopsies demonstrating squamous cell metaplasia consistent with pulmonary inflammatory bowel disease. The patient was unable to be weaned off steroids and, in the presence of an elevated fractional expired nitric oxide, dupilumab was trialled, which resulted in minimal improvement in his symptoms.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70359"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case of Syndrome of Inappropriate Secretion of Antidiuretic Hormone Induced by Selpercatinib in a Patient With RET Fusion Gene-Positive Non-Small Cell Lung Cancer.","authors":"Yuma Tanaka, Naoya Ikegami, Kodai Miyamoto, Yusuke Shingu, Nobuhiro Okagaki, Hiroto Sakamoto, Tsukasa Nakanishi, Satoshi Nakamura, Kazuki Matsumura, Masakuni Ueyama, Yusuke Kaji, Seishu Hashimoto, Eisaku Tanaka, Yoshio Taguchi, Yuki Ohsumi, Tatsuo Nakagawa, Satoshi Matsunaga, Takashi Hajiro","doi":"10.1002/rcr2.70352","DOIUrl":"10.1002/rcr2.70352","url":null,"abstract":"<p><p>An 80-year-old woman with a lung nodule in the right lower lobe and pleural thickening was diagnosed with lung adenocarcinoma by a surgical lung biopsy. The oncogene panel test showed a positive RET-fusion gene mutation, and selpercatinib was administered as a first-line treatment. She developed severe hyponatremia and was subsequently diagnosed with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Discontinuing selpercatinib and initiating demethyltetracycline gradually improved SIADH. After confirming that sodium levels had returned to normal, we resumed and continued selpercatinib at a reduced dose without a recurrence of SIADH. This case suggests that selpercatinib could cause SIADH as an adverse event.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 10","pages":"e70352"},"PeriodicalIF":0.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}