Case Reports in Pulmonology最新文献

{"title":"Efficacy of Omalizumab Therapy in an Asthmatic with Low IgE.","authors":"Divya R,&nbsp;Rajesh Venkitakrishnan,&nbsp;Jolsana Augustine,&nbsp;Melcy Cleetus","doi":"10.1155/2020/8898454","DOIUrl":"https://doi.org/10.1155/2020/8898454","url":null,"abstract":"<p><p>Asthma is one of the most common respiratory diseases encountered in clinical practice. Although the vast majority of asthmatics can be adequately controlled with inhaled steroids and other preventer medications, a small proportion remain uncontrolled. Anti-IgE treatment with omalizumab has been proposed in patients as a preferred approach in step 5 asthma therapy according to GINA guidelines. Although therapy with this molecule is approved for patients with atopic asthma and pretreatment serum IgE levels of 30-1500 only, there have been a few reports of its efficacy in subjects outside this reference IgE range. We report the case of a middle-aged lady with severe corticosteroid-dependent asthma and low serum IgE levels who was successfully treated with 9 months of omalizumab therapy. She gained good asthma control and was tapered off steroid use by the fifth month of therapy with omalizumab. The case report stresses the need for further investigation into expanding the spectrum of omalizumab usage in asthma beyond the current IgE suitability range.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8898454"},"PeriodicalIF":0.0,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8898454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38453478","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 Vein Occlusion and Lung Infarction after Radiofrequency Ablation of Atrial Fibrillation.","authors":"Julyan Al Fori,&nbsp;Maryam Al Belushi,&nbsp;Mohammed Al Shuraiqi,&nbsp;Ghalia Al Mohanny,&nbsp;Rashid Al Umairi,&nbsp;Nasser Al Busaidi","doi":"10.1155/2020/2357846","DOIUrl":"https://doi.org/10.1155/2020/2357846","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein (PV) radiofrequency ablation (RFA) is an effective technique for a selected group of patients with atrial fibrillation (AF) refractory to antiarrhythmic drugs (Alfudhili et al., 2017). However, pulmonary vein occlusion is a potentially rare, sometimes severe, complication which may present clinically as nonspecific respiratory symptoms, signifying pulmonary vein stenosis, that are often underrecognized or misdiagnosed, leading to progression of the low-grade stenosis to complete occlusion if not treated with timely intervention (Alfudhili et al., 2017). <i>Case Presentation</i>. We report the first case of haemoptysis, three months postradiofrequency ablation (i.e., late complication) secondary to pulmonary vein occlusion that was diagnosed by computed tomography angiogram (CTA), which showed occlusion of 2 out of 4 native pulmonary veins.</p><p><strong>Conclusion: </strong>The cause of haemoptysis in this patient was pulmonary vein occlusion, secondary to radiofrequency ablation, as demonstrated in the CTA.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"2357846"},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2357846","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38278925","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":"Azathioprine Hypersensitivity Syndrome during Treatment of Severe Interstitial Lung Disease with Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis.","authors":"Eri Nakano,&nbsp;Tomohiko Asakawa,&nbsp;Mea Asou,&nbsp;Eri Nohara,&nbsp;Tomoyuki Seki,&nbsp;Makoto Araki","doi":"10.1155/2020/8852441","DOIUrl":"https://doi.org/10.1155/2020/8852441","url":null,"abstract":"<p><p>Azathioprine is used to treat anti-neutrophil cytoplasmic antibody- (ANCA-) associated vasculitis. Azathioprine hypersensitivity syndrome is often missed. An 81-year-old man undergoing treatment for interstitial pneumonia developed a high fever and was diagnosed with ANCA-associated vasculitis based on an elevated myeloperoxidase- (MPO-) ANCA titer and renal biopsy findings. After induction therapy, his clinical symptoms improved, but his MPO-ANCA remained elevated (>300 U·L^-1) and hematuria persisted. Prednisolone plus azathioprine was administered as maintenance therapy. Three exacerbations of the inflammatory response occurred during the subsequent 3 months. In each instance, we suspected opportunistic infection or a flare-up of vasculitis. The first exacerbation was treated with an increased prednisolone dose and antibiotics. At the onset of the second exacerbation, which was accompanied by systemic erythema, we stopped azathioprine and administered antibiotics. The third exacerbation, which occurred the day after restarting azathioprine, involved a fever with chills and an acute inflammatory reaction; we therefore suspected an azathioprine allergy. A drug provocation test was performed, and a hyperinflammatory response was observed. The patient received prednisolone (15 mg·day^-1) monotherapy; no further fever was observed during the subsequent 2 months. We therefore diagnosed azathioprine hypersensitivity syndrome. Under treatment with prednisolone (5 mg·day^-1) and mycophenolate mofetil (1 g·day^-1) (replacing the azathioprine), no signs of relapse or infection have occurred for more than two years. Renal function and the pulmonary lesions are stable, although the high MPO-ANCA titer and hematuria persist. The diagnosis of azathioprine hypersensitivity is often delayed because of the difficulty in identifying the relationship between immunosuppressive agents and hypersensitivity and in distinguishing this from infection or relapse of the primary disease. The misdiagnosis of azathioprine hypersensitivity leads to unnecessary treatment; thus, clinicians should consider allergic reactions specific to azathioprine when switching from induction to maintenance therapy.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8852441"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8852441","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38186180","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":"Postpartum Pulmonary Hypertension Masquerading as Submassive Pulmonary Embolism: A Case Report and a Literature Review.","authors":"Mahmood Mubasher,&nbsp;Amir Hanafi,&nbsp;Tausif Syed,&nbsp;Abir Zinal,&nbsp;Ibrahim Y Abubeker,&nbsp;Mouhand F H Mohamed,&nbsp;Mohan Rao,&nbsp;Ryan Hoefen,&nbsp;Mohammed Danjuma","doi":"10.1155/2020/8899562","DOIUrl":"https://doi.org/10.1155/2020/8899562","url":null,"abstract":"<p><p>Postpartum pulmonary hypertension (PPPHT) is an extremely rare disorder, with few reported cases. Late diagnosis and treatment are associated with significant morbidity and mortality. We present an 18-year-old female patient who presented four-week postpartum with a typical submissive pulmonary embolism picture subsequently diagnosed as postpartum pulmonary hypertension. The patient had an excellent response to treatment, with a dramatic improvement in her functional status. The authors aim to urge physicians to keep this rare disorder in mind as timely and accurate diagnosis is crucial for management-additionally, the importance of counseling patients about the imminent risks associated with planned future pregnancies.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8899562"},"PeriodicalIF":0.0,"publicationDate":"2020-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8899562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38145847","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 Rare Paraneoplastic Syndrome of Lung Cancer.","authors":"R Azzeddine,&nbsp;L Herrak,&nbsp;A Rhanim,&nbsp;A Jniene,&nbsp;M Elftouh,&nbsp;L Achachi","doi":"10.1155/2020/7891325","DOIUrl":"https://doi.org/10.1155/2020/7891325","url":null,"abstract":"<p><p>Achalasia is a neurodegenerative motor disease of the esophagus resulting mainly from a loss of function of the lower esophageal sphincter, the pathophysiology of which is still poorly understood. Its incidence is rare-it is 1.6 per 100,000-and its occurrence in the context of paraneoplastic syndrome has been rarely described in the literature. We report a rare case of paraneoplastic achalasia associated with lung cancer.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"7891325"},"PeriodicalIF":0.0,"publicationDate":"2020-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7891325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38145846","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":"Invasive Thymoma with Right Upper Lobe Endobronchial Lesion and Autoimmune Enteropathy.","authors":"Saumil Datar,&nbsp;Henriette De La Garza,&nbsp;Aditya Srinivasan,&nbsp;Gloria Iliescu,&nbsp;Neda Kalhor,&nbsp;Horiana Grosu","doi":"10.1155/2020/6396915","DOIUrl":"https://doi.org/10.1155/2020/6396915","url":null,"abstract":"<p><p>Thymomas are slow-growing neoplasia arising from the epithelial cells of the thymus that usually present with respiratory symptoms, superior vena cava syndrome, or parathymic syndromes. Approximately 30% of thymomas develop myasthenia gravis. An additional 5% of patients with thymomas have other systemic syndromes, including rheumatoid arthritis, thyroiditis, red cell aplasia, systemic lupus erythematosus, and Cushing syndrome. Rarely, patients can present with diarrhea due to thymoma-associated autoimmune gastrointestinal pathologies that include Good syndrome (acquired hypogammaglobulinemia), thymoma- associated multiorgan autoimmunity, and autoimmune enteropathy. We present an uncommon and interesting case of an invasive metastatic thymoma with right upper lobe endobronchial lesion and autoimmune enteropathy in a 27-year-old female. The novelty of this case lay in the findings of extensive metastatic thymoma with right upper lobe endobronchial disease and autoimmune diarrhea.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"6396915"},"PeriodicalIF":0.0,"publicationDate":"2020-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6396915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38135942","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":"Review of Cases of E-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) and Brief Review of the Literature.","authors":"Amr Essa,&nbsp;Jeffrey Macaraeg,&nbsp;Nikhil Jagan,&nbsp;Daniel Kwon,&nbsp;Saboor Randhawa,&nbsp;Matthew Kruse,&nbsp;Stanley Thomas,&nbsp;Manasa Velagapudi,&nbsp;John Horne,&nbsp;Shraddha Narechania,&nbsp;Michael Kaster,&nbsp;Carrie Valenta,&nbsp;Venketraman Sahasranaman,&nbsp;Douglas Moore","doi":"10.1155/2020/1090629","DOIUrl":"https://doi.org/10.1155/2020/1090629","url":null,"abstract":"<p><p>Since the appearance of the E-Cigarette in the early 2000s, its industry, popularity, and prevalence have risen dramatically. In the past, E-Cigarette use with the vaping of nicotine or cannabis products had been associated with a few reported cases of lung injury. However, in 2019, thousands of cases of E-Cigarette or vaping product use-associated lung injury (EVALI) were reported in the United States. Evidence linked this outbreak with vaping of tetrahydrocannabinol (THC). We report two confirmed cases of EVALI and their associated clinical, radiologic, and pathologic features. This report supports the growing body of information regarding EVALI. It also discusses various substances, particularly vitamin E acetate, which has been suggested as a causative agent.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"1090629"},"PeriodicalIF":0.0,"publicationDate":"2020-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1090629","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38103547","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 Rare Cause of Cough: Tracheobronchial Myxoid Spindle Cell Lipoma.","authors":"Jose A Rodriguez,&nbsp;Christopher R Weil,&nbsp;Jose F Ramirez","doi":"10.1155/2020/9727281","DOIUrl":"https://doi.org/10.1155/2020/9727281","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial lipomas are a particularly rare form of benign lung neoplasms, with an incidence of 0.1-0.4%. They are often clinically silent, though present with nonspecific symptoms that can result in extensive workup or significant delay prior to diagnosis, as presented in this case. <i>Case Presentation</i>. A 61-year-old male presented with chronic productive cough and occasional dyspnea and a 10-year history of clinically diagnosis of intermittent, exercise-induced asthma, nonresponsive to bronchodilators, and with normal pulmonary function tests. A chest ray showed a band-like opacity in the right middle lobe of the lung and a CT of the chest showed right lung atelectasis with a soft tissue mass in the right main bronchus. The patient underwent bronchoscopy with biopsy, which demonstrated an endobronchial myxoid spindle cell lipoma. The lesion was subsequently removed by a bronchoscopic snare. The patient's asthmatic-like symptomatology resolved after the mass was excised.</p><p><strong>Conclusion: </strong>Though rare, endobronchial lipomas characteristically present with nonspecific signs and symptoms and thus can be easily mistaken for other medical conditions, delaying diagnosis and prolonging symptoms.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"9727281"},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9727281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38057358","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":"E-Cigarette- and Vaping-Related Lung Injury (EVALI) at a Regional Hospital System in South Carolina.","authors":"Daniel Temas,&nbsp;Armin Meyer","doi":"10.1155/2020/5370606","DOIUrl":"https://doi.org/10.1155/2020/5370606","url":null,"abstract":"<p><p>We report on four cases of severe lung injury and respiratory failure attributed to E-cigarette use that presented between July and August, 2019. The patients described were relatively healthy without clinically significant history of lung disease. Each developed severe acute respiratory distress shortly following E-cigarette use. In each case, the patients initially presented with considerable hypoxia and infectious-appearing pattern with elevated inflammatory markers on laboratory values. Imaging studies demonstrated a consistent pattern of widespread bilateral interstitial infiltrates with a medial distribution. All but one of the cases involved the admitted use of THC oil in E-cigarettes. There was rapid progression of illness requiring increased supplemental oxygen and in two cases, requiring urgent intubation and mechanical ventilation. No infectious organism was isolated in any case, and patients improved rapidly with the initiation of steroids. These are among the first cases reported in South Carolina and are consistent with similar cases that have been reported around the country.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"5370606"},"PeriodicalIF":0.0,"publicationDate":"2020-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5370606","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38019290","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":"Hyperbaric Oxygen Therapy of an Adolescent Stem Cell Transplantation Recipient with Hemorrhagic Cystitis and BK Virus.","authors":"David López,&nbsp;Abdullah Alismail,&nbsp;Laren D Tan","doi":"10.1155/2020/3465412","DOIUrl":"https://doi.org/10.1155/2020/3465412","url":null,"abstract":"<p><p>Hyperbaric oxygen therapy (HBOT) continues to show effectiveness in the treatment of several diseases and benefits such as fibroblast proliferation, capillary angiogenesis, and decreasing edema, especially in hemorrhagic cystitis (HC). We report a case of a 15-year-old male with chronic myelogenous leukemia status posthaploidentical stem cell transport with BK virus in the United States to be treated by HBOT. The patient received a total of 30 HBOT treatments for 90 minutes at 2 ATA. After HBOT treatments, patient showed signs of improvements such as cessation of hemorrhage cystitis. The findings of this case support and shows that there is growing evidence for the use of HBOT as adjunctive therapy for patients with BK virus associated with HC after stem cell transplantation.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"3465412"},"PeriodicalIF":0.0,"publicationDate":"2020-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3465412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37976969","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}