Respiratory Medicine Case Reports最新文献_第3页

Effective management of refractory chylothorax associated with elderly onset Gorham-Stout disease: A case report

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2025.102195

Haruna Yamaki , Masaru Ejima , Takaya Takeguchi , Chihiro Kagohashi , Shunya Hanawa , Natsushi Kubota , Kotaro Hanawa , Seishi Higashi , Satoko Hanada , Reiko Taki

{"title":"Effective management of refractory chylothorax associated with elderly onset Gorham-Stout disease: A case report","authors":"Haruna Yamaki , Masaru Ejima , Takaya Takeguchi , Chihiro Kagohashi , Shunya Hanawa , Natsushi Kubota , Kotaro Hanawa , Seishi Higashi , Satoko Hanada , Reiko Taki","doi":"10.1016/j.rmcr.2025.102195","DOIUrl":"10.1016/j.rmcr.2025.102195","url":null,"abstract":"<div><div>Gorham-Stout disease (GSD) is a rare vascular disease of lymphatic origin characterized by progressive osteolysis that commonly causes chylothorax owing to the leakage of lymphatic fluid from dissolved bones. We report a case of refractory chylothorax that was diagnosed as elderly onset GSD and treated successfully using multidisciplinary approaches. A 78-year-old male presented with persistent cough and shortness of breath caused by massive left pleural effusion. Thoracentesis and pleural biopsy revealed an initial diagnosis of idiopathic chylothorax. The patient underwent continuous thoracic drainage and several percutaneous thoracic duct embolization with subcutaneous octreotide acetate injection and a low-fat diet. Thoracoscopic surgery was performed to control the secondary empyema through the drain tube and repair the pleural lesions with lymphatic leakage. A sufficient decrease in pleural fluid volume allowed temporary removal of the thoracic drainage tube. However, thoracic drainage was resumed for refractory chylothorax when the patient gradually developed neck pain after three months. Computed tomography, magnetic resonance imaging, and bone scintigraphy revealed growing osteolytic lesions in the cervical and thoracic spine regions, and biopsy demonstrated numerous dilated thin-walled capillary structures with lymphocyte infiltrates. After diagnosing GSD and introducing sirolimus, the patient's symptoms improved, and thoracic drainage was discontinued. Multidisciplinary treatments successfully halted disease progression for over a year. The case report emphasizes the systematic examination to identify rare etiology in refractory chylothorax treatment.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"55 ","pages":"Article 102195"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685859","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}

引用次数: 0

Safety and efficacy of osimertinib 160 mg daily given concurrently with a strong CYP3A4 inducer 奥希替尼每天160毫克与强CYP3A4诱导剂同时服用的安全性和有效性

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2025.102200

Mostafa Aglan , Erin Spyropoulous , Joel Oster , Paul J. Hesketh , A.J. Piper-Vallillo

{"title":"Safety and efficacy of osimertinib 160 mg daily given concurrently with a strong CYP3A4 inducer","authors":"Mostafa Aglan , Erin Spyropoulous , Joel Oster , Paul J. Hesketh , A.J. Piper-Vallillo","doi":"10.1016/j.rmcr.2025.102200","DOIUrl":"10.1016/j.rmcr.2025.102200","url":null,"abstract":"<div><h3>Introduction</h3><div>Osimertinib remains the standard first-line therapy for patients with advanced <em>EGFR</em>-mutant NSCLC, at least in part due to its improved CNS penetrance compared to earlier generation EGFR TKIs. Strong CYP3A4-inducing medications are known to reduce the effective concentration of osimertinib, prompting the recommendation to double the standard osimertinib dose from 80 to 160 mg daily. However, little is known about the real-world safety and efficacy of osimertinib given in combination with long term CYP3A4 inducer use. We detail, to our knowledge, the first reported case of a patient receiving an escalated osimertinib dosage concurrent with a potent CYP3A4 inducer.</div></div><div><h3>Case presentation</h3><div>A 69-year-old-female with a long-standing history of a seizure disorder was diagnosed with stage IV EGFR exon 19 deletion positive lung adenocarcinoma. After a failed trial to wean the patient off phenytoin, osimertinib at a dose of 160 mg in combination with phenytoin was recommended based on existing clinical guidelines. She achieved a partial response and continues with stable disease for more than 32 months from initiation of osimertinib. Additionally, she tolerated osimertinib well with minimal side effects although with persistent dyspnea of unclear etiology.</div></div><div><h3>Conclusion</h3><div>Our case illustrates that 160 mg of osimertinib administered concurrently with a strong CYP3A4 inducer can be given safely and with retained efficacy in treating CNS metastatic EGFR-positive non-small cell lung cancer.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"55 ","pages":"Article 102200"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800471","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}

引用次数: 0

Bronchoscopic lung volume reduction complicated by ipsilateral pleural effusion 支气管镜下肺体积缩小合并同侧胸腔积液。

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2024.102151

Marc Assaad, Wasif Shamsi, Anthony Loschner, Maria del Mar Cirino-Marcano

引用次数: 0

Extensively drug-resistant Acinetobacter baumannii lung abscess and empyema in a patient with fulminant mycoplasma pneumoniae pneumonia 暴发性肺炎支原体肺炎患者的广泛耐药鲍曼不动杆菌肺脓肿和脓肿。

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2024.102150

Siyu Yang, Chaojie Wei

引用次数: 0

Klinefelter syndrome diagnosed at autopsy and small-cell lung carcinoma

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2025.102166

Haruyasu Sakuranaka , Ryoma Tanaka , Yuji Yamakawa , Shiho Yamada , Komei Igei , Yasuo Asai

引用次数: 0

Recurrent “transient ischemic attacks” caused by pulmonary arteriovenous malformation

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2025.102172

Jorrit B.A. Welling , Mascha Schuurmans , T. David Koster

引用次数: 0

Arduous management in treatment of elderly patient with pulmonary arterial hypertension and cardiopulmonary comorbidities

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2025.102174

Yu Enomoto , Kei Kusaka , Kengo Sato , Keita Takeda , Masahiro Kawashima , Yoshiteru Morio

引用次数: 0

Reduced tracheal stenosing effect of nintedanib in a patient with scarred posttraumatic tracheal stenosis and airflow limitation - a case report

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2025.102168

Stefanie Klampfleitner , Andreas Fertl , Ositha Prinz , Martin Doerfler-Schalm , Dieter Munker , Markus O. Henke

{"title":"Reduced tracheal stenosing effect of nintedanib in a patient with scarred posttraumatic tracheal stenosis and airflow limitation - a case report","authors":"Stefanie Klampfleitner , Andreas Fertl , Ositha Prinz , Martin Doerfler-Schalm , Dieter Munker , Markus O. Henke","doi":"10.1016/j.rmcr.2025.102168","DOIUrl":"10.1016/j.rmcr.2025.102168","url":null,"abstract":"<div><h3>Introduction</h3><div>Nintedanib is a tyrosine kinase inhibitor and has been approved for the treatment of idiopathic pulmonary fibrosis (IPF) since 2020. In Clinical trials, the antifibrotic effect of nintedanib was shown.</div></div><div><h3>Case</h3><div>A 60-year-old female medical assistant, infected with COVID-19 in 10/2020, experienced a complicated course of disease leading to tracheal stenosis. Various interventions, including stent placements and tracheal surgeries, were performed. Due to recurrent restenosis, the patient was treated with nintedanib, a tyrosine kinase inhibitor used in idiopathic pulmonary fibrosis. The treatment spanned 306 days, during which the patient showed stability in pulmonary function. Nintedanib demonstrated a potential anti-inflammatory effect, reducing the frequency of interventions and prolonging stent-free intervals. The results suggest possible efficacy of nintedanib in managing scar-related granulation tissue, highlighting its potential in treating tracheal stenosis.</div></div><div><h3>Conclusion</h3><div>This case shows a decreased need for interventions, and the longer duration of stent placement may suggest a potential role for nintedanib in diminishing hypertrophic scarring, possibly through an anti-inflammatory effect. Further exploration of this potential in additional clinical trials would be valuable.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"54 ","pages":"Article 102168"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349529","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}

引用次数: 0

A young female with multiple cavitary lung lesions

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2025.102182

Amina Pervaiz , Sharad Oli , Waed Alkaram , Shefali Godara , Suzanne M. Jacques , Khaled Alshabani

{"title":"A young female with multiple cavitary lung lesions","authors":"Amina Pervaiz , Sharad Oli , Waed Alkaram , Shefali Godara , Suzanne M. Jacques , Khaled Alshabani","doi":"10.1016/j.rmcr.2025.102182","DOIUrl":"10.1016/j.rmcr.2025.102182","url":null,"abstract":"<div><div>A 21-year-old female with a history of HPV and recurrent laryngeal papillomatosis has required frequent removal of laryngeal papilloma through direct laryngoscopy and has been treated with interferon alpha since she was 7 months old. She now presented with worsening dyspnea, hemoptysis, night sweats and significant weight loss. Infectious work up was negative. CT thorax showed significantly increasing right lower lobe mass with thick septation, debris and fluid concerning for malignant transformation. CT-guided biopsy of the mass showed features concerning for necrotic squamous cell carcinoma (SCC). Multidisciplinary tumor board classified this as malignant transformation due to bilateral lungs involvement and aggressive nature of the disease and recommended treatment with combination of chemotherapy and immunotherapy. Unfortunately, she continued to have declining performance status with multiple hospitalizations for hypoxic respiratory failure. Repeat CT scan of the chest showed progression of the lung lesions with extensive mediastinal involvement. She was unable to tolerate any additional therapy and decided with her family to pursue inpatient hospice. Malignant transformation into squamous cell carcinoma in recurrent respiratory papillomatosis is rare and is associated with worse outcomes.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"55 ","pages":"Article 102182"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685861","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}

引用次数: 0

Acute eosinophilic pneumonia caused by an exploding mobile battery: A case report

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Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI: 10.1016/j.rmcr.2025.102196

Hiroe Aramaki , Masafumi Shimoda , Kozo Morimoto , Kozo Yoshimori , Ken Ohta , Yoshiaki Tanaka

引用次数: 0