Respirology Case ReportsPub Date : 2024-11-25eCollection Date: 2024-11-01DOI: 10.1002/rcr2.70052
Matteo Schisano, Alessandro Libra, Giorgio Morana, Carlo Vancheri, Lucia Spicuzza
{"title":"Adaptive servo-ventilation for the treatment of intrathecal baclofen-induced central sleep apnea: A case report.","authors":"Matteo Schisano, Alessandro Libra, Giorgio Morana, Carlo Vancheri, Lucia Spicuzza","doi":"10.1002/rcr2.70052","DOIUrl":"10.1002/rcr2.70052","url":null,"abstract":"<p><p>Baclofen is a common muscle relaxant agent used in a number of neurological disorders acting at central level and potentially causing adverse respiratory events, still largely unknown at therapeutic doses. We present the case of a young woman with spastic tetraparesis secondary to perinatal asphyxia treated with a standard dose of intrathecal baclofen who developed nocturnal symptoms, somnolence and memory loss during the day. Nocturnal cardio-respiratory sleep monitoring showed a high number of central sleep apneas (CSA). The patient was adapted and treated with a positive air pressure device, Adaptative Servo-Ventilator, specific designed to treat CSA particularly in patients with heart failure. The treatment was well tolerated and within few days CSA was reversed. The patient reported a feeling of restful sleep and disappearance of morning tiredness. The efficacy of the treatment was verified with nocturnal cardio-respiratory monitoring after 2 months and complete resolution of all symptoms was also confirmed.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70052"},"PeriodicalIF":0.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717508","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}
Anna Russo, Vittorio Viglione, Linda Franzese, Vittorio Patanè, Tullio Valente, Fabio Perrotta, Alfonso Reginelli
{"title":"Unveiling the radiological odyssey: Navigating the interstitial with artificial intelligence.","authors":"Anna Russo, Vittorio Viglione, Linda Franzese, Vittorio Patanè, Tullio Valente, Fabio Perrotta, Alfonso Reginelli","doi":"10.1002/rcr2.1413","DOIUrl":"10.1002/rcr2.1413","url":null,"abstract":"<p><p>This study examines the radiological and clinical evolution of a case involving mixed idiopathic pulmonary fibrosis and chronic hypersensitivity pneumonitis, utilizing conventional CT imaging and artificial intelligence tool. Through a series of exams and clinical assessments, the patient was followed for over 3 years, highlighting the challenge in differentiating these interstitial pathologies and the importance of a multidisciplinary approach. The radiological progression towards pulmonary fibrosis was correlated with clinical symptoms, emphasizing the significance of early diagnosis and regular follow-up. The combined use of advanced technologies offers a more comprehensive framework in managing complex lung diseases, enhancing the quality of care and understanding of interstitial pathologies.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e01413"},"PeriodicalIF":0.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717567","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 : 2024-11-25eCollection Date: 2024-11-01DOI: 10.1002/rcr2.70064
Roger Winters, Lindsay M Forbes, Dunbar Ivy, Carlyne Cool, Bryan D Park, Peter Hountras, David Badesch, Sue Gu, Edda Spiekerkoetter, Roham Zamanian, Stacey LeierGluck, Todd M Bull
{"title":"Case report: A finding of PVOD and PAH in first degree relatives suggests shared heritable risk and overlapping features of both pulmonary vascular diseases.","authors":"Roger Winters, Lindsay M Forbes, Dunbar Ivy, Carlyne Cool, Bryan D Park, Peter Hountras, David Badesch, Sue Gu, Edda Spiekerkoetter, Roham Zamanian, Stacey LeierGluck, Todd M Bull","doi":"10.1002/rcr2.70064","DOIUrl":"10.1002/rcr2.70064","url":null,"abstract":"<p><p>Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary vascular disease that is difficult to distinguish clinically from pulmonary arterial hypertension (PAH). Multiple genes have been implicated in disease pathogenesis in PAH and PVOD and the diseases are thought to be genetically distinct. In this report we present a case of first-degree relatives with pathological evidence of PVOD and PAH. The index patient was diagnosed with PAH at age 42, was treated with escalating pulmonary vasodilator therapy, but eventually succumbed to her disease. On autopsy, her pathology was consistent with PAH. Her son was diagnosed with PAH at age 16, did well on pulmonary vasodilator therapy for over 10 years, but ultimately developed refractory right ventricular failure and received a heart and lung transplantation. Pathology of his explanted lung was consistent with PVOD, and genetic testing was negative for recognized variants that cause PAH or PVOD.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70064"},"PeriodicalIF":0.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717436","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":"Immune checkpoint inhibitor-induced autoimmune limbic encephalitis with positivity for anti-Hu antibodies in a patient with small-cell lung cancer: A case report and literature review.","authors":"Lynn Nakahara, Shun Matsuura, Ryo Suzuki, Akira Kawamura, Takumi Nagasaki, Takafumi Masuda, Kotaro Yamada, Ryuuichi Nakamura, Toshiya Hiramatsu, Norimichi Akiyama, Kazuki Tanaka, Naoki Koshimizu, Shota Igasaki","doi":"10.1002/rcr2.70070","DOIUrl":"10.1002/rcr2.70070","url":null,"abstract":"<p><p>In recent years, there has been an increasing number of studies on neurological symptoms induced as paraneoplastic neurological syndrome (PNS) or neurological immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitors (ICIs). Herein, we report a 68-year-old male patient with small-cell lung cancer who developed memory impairment and autonomic nervous system dysfunction after three courses of carboplatin, etoposide, and durvalumab therapy. Brain magnetic resonance imaging revealed hyperintense areas restricted to the bilateral temporal lobes. Moreover, based on the blood test results, the patient was strongly positive for anti-neuronal nuclear antibodies. Hence, he was diagnosed with autoimmune limbic encephalitis (ALE). Corticosteroid pulse therapy was administered. After treatment, the patient exhibited gradual improvement in memory impairment. However, while tapering the prednisolone dose, the patient exhibited relapse of memory disturbance owing to ALE. It is challenging to distinguish PNS from neurological irAEs. However, ICI-induced ALE with positivity for anti-Hu antibodies has an extremely poor prognosis.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70070"},"PeriodicalIF":0.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717553","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 : 2024-11-25eCollection Date: 2024-11-01DOI: 10.1002/rcr2.70068
Ad Rian Chong, Khai Lip Ng, Nai-Chien Huan, Nur Husna Mohd Aminudin, Maryam Ahmad Sharifuddin, Raja Nor Adilla Raja Rahaizat, Kasuma Mohamed Nordin
{"title":"Unveiling a rare haemorrhagic malignant pleural effusion: The role of medical thoracoscopy in diagnosing primary pleural angiosarcoma.","authors":"Ad Rian Chong, Khai Lip Ng, Nai-Chien Huan, Nur Husna Mohd Aminudin, Maryam Ahmad Sharifuddin, Raja Nor Adilla Raja Rahaizat, Kasuma Mohamed Nordin","doi":"10.1002/rcr2.70068","DOIUrl":"10.1002/rcr2.70068","url":null,"abstract":"<p><p>Primary pleural angiosarcoma (PPA) is a rare and challenging tumour to diagnose, often mistaken for other malignancies such as mesothelioma and lung cancer due to overlapping clinical and imaging features. We report a 52-year-old woman who presented with progressive shortness of breath and pleuritic chest pain. Imaging studies and thoracentesis revealed a large haemorrhagic left pleural effusion. Medical thoracoscopy (MT) showed a thickened and lobulated parietal pleura with multiple nodular lesions. Histopathological examination confirmed a diagnosis of angiosarcoma, characterized by pleomorphic tumour cells, a high Ki67 proliferation index and positive immunohistochemical markers, including CD31, D2-40, Vimentin, and Factor VIII. Tragically, the patient developed a hospital-acquired infection and passed away before any definitive treatment for the angiosarcoma could be initiated. This case underscores the diagnostic complexities of PPA and highlights the utility of MT in identifying this rare malignancy.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70068"},"PeriodicalIF":0.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717562","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 : 2024-11-21eCollection Date: 2024-11-01DOI: 10.1002/rcr2.70067
Nathan Harb, Julia Fattore, Mayuran Saththianathan, Stephen Parsons
{"title":"Thoracic splenosis: Precision medicine can prevent thoracic surgery.","authors":"Nathan Harb, Julia Fattore, Mayuran Saththianathan, Stephen Parsons","doi":"10.1002/rcr2.70067","DOIUrl":"10.1002/rcr2.70067","url":null,"abstract":"<p><p>Thoracic splenosis is a rare condition referring to the auto-transplantation of splenic tissue into the thoracic cavity following splenic trauma. We present a case of thoracic splenosis in a 62-year-old man who at the age of 17 suffered three gunshot wounds to the posterior thorax and abdomen, requiring a splenectomy and intercostal catheter insertion. In 2007, he underwent a thoracotomy and biopsy of a left sided pulmonary mass which was complicated by a haemothorax requiring an emergent return to theatre and rib resection to achieve haemostasis. The biopsy revealed granulation tissue. In 2023, Technetium-99m (Tc-99m) heat-damaged erythrocyte scintigraphy confirmed the diagnosis of thoracic splenosis. This case highlights the importance of recognizing this uncommon condition to prevent unnecessary investigation, as well as the use of Tc-99m heat-damaged erythrocyte scintigraphy to confirm the diagnosis.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70067"},"PeriodicalIF":0.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689152","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 : 2024-11-19eCollection Date: 2024-11-01DOI: 10.1002/rcr2.70061
Nai-Chien Huan, Khai Lip Ng, Larry Ellee Nyanti, Jing Yi Khaw, Jiun Hang Lee, Nur Husna Mohd Aminudin, Dahziela Yunus, Nusaibah Azman, Maryam Ahmad Sharifuddin, Hema Yamini Ramarmuty, Kunji Kannan Sivaraman Kannan
{"title":"Utilizing medical thoracoscopy for the diagnosis of B-cell lymphoma presenting with pleural effusion: A case series.","authors":"Nai-Chien Huan, Khai Lip Ng, Larry Ellee Nyanti, Jing Yi Khaw, Jiun Hang Lee, Nur Husna Mohd Aminudin, Dahziela Yunus, Nusaibah Azman, Maryam Ahmad Sharifuddin, Hema Yamini Ramarmuty, Kunji Kannan Sivaraman Kannan","doi":"10.1002/rcr2.70061","DOIUrl":"10.1002/rcr2.70061","url":null,"abstract":"<p><p>A third of patients with non-Hodgkin's lymphoma (NHL) develop pleural effusion during the disease course for various reasons. In most cases, lymphoma-related pleural effusion is a manifestation of widespread systemic disease, signifying a high tumour burden and therefore, a poorer prognosis. On the other hand, primary pleural lymphomas (PPLs) exhibit exclusive or dominant involvement of serous cavities, without detectable solid tumour masses. PPL is an uncommon disease and is of two types: primary effusion lymphoma (PEL) and diffuse large B-cell lymphoma associated with chronic inflammation (DLBCL-CI). PPLs not related to PELs and DLBCL-CIs are exceedingly rare. Herein, we describe four patients with biopsy proven B-cell NHL. One had no extra-pleural involvement at the time of diagnosis, indicating PPL. In all cases, histopathological examination of pleural biopsies obtained via medical thoracoscopy (MT) were crucial in clinching the final diagnosis. Clinicians are alerted to the potential relationship between exudative effusion and NHL as well as the role of MT in the diagnosis of B-cell NHL.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70061"},"PeriodicalIF":0.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677194","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 : 2024-11-18eCollection Date: 2024-11-01DOI: 10.1002/rcr2.70066
William Griffin, Nina Mac Auley Srinivasan, Aurelie Fabre, David Healy
{"title":"An incidental finding of a pleural based schwannoma.","authors":"William Griffin, Nina Mac Auley Srinivasan, Aurelie Fabre, David Healy","doi":"10.1002/rcr2.70066","DOIUrl":"10.1002/rcr2.70066","url":null,"abstract":"<p><p>A man in his 40s was incidentally found to have a large right sided apical pleural based mass on imaging. This was further investigated with a CT-guided biopsy. Histological and immunohistochemical analysis of the tissue revealed a diagnosis of a Schwannoma: a rare, slow-growing benign nerve sheath tumour. Only a handful of pleural based Schwannomas have been documented in the literature. They account for about 0.2% of lung tumours. The patient was referred to cardiothoracic surgery who advised surgical resection of the mass, which he is awaiting. Here, we report a rare case of a pleural based Schwannoma which was diagnosed incidentally on chest x-ray.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70066"},"PeriodicalIF":0.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668828","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 : 2024-11-18eCollection Date: 2024-11-01DOI: 10.1002/rcr2.70065
Ken Ka Pang Chan, Jason Siu Hang Wong, Wing Ho Yip
{"title":"Superimposed pleural infection in cirrhotic chylothorax.","authors":"Ken Ka Pang Chan, Jason Siu Hang Wong, Wing Ho Yip","doi":"10.1002/rcr2.70065","DOIUrl":"10.1002/rcr2.70065","url":null,"abstract":"<p><p>Chylothorax contains an abundant amount of immunoglobulins and white blood cells, leading to the belief that superimposed pleural infection is unlikely. We report two cases of biochemically confirmed chylothorax due to cirrhosis, complicated by superimposed pleural infection following repeated pleural interventions. These findings highlight the potential for superimposed infection in chylothorax and challenge the belief in the bacteriostatic effect of chyle. Clinical vigilance is essential to consider this possibility if features of infection arise during the management of chylothorax.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70065"},"PeriodicalIF":0.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668834","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 : 2024-11-18eCollection Date: 2024-11-01DOI: 10.1002/rcr2.70063
Harshana Bandara, Michael D Davis, Stephen J Fowler
{"title":"Plastic bronchitis in an adult.","authors":"Harshana Bandara, Michael D Davis, Stephen J Fowler","doi":"10.1002/rcr2.70063","DOIUrl":"10.1002/rcr2.70063","url":null,"abstract":"<p><p>Plastic bronchitis is rare in adult pulmonology and has a wide range of aetiology. Cast analysis is key in narrowing down the differential diagnosis of plastic bronchitis. If suspected of having lymphocytic PB, complete imaging to evaluate thoracic lymphatics is important to find out the potential causes for PB.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 11","pages":"e70063"},"PeriodicalIF":0.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677193","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}