Respirology Case Reorts

Masaharu Aga, Aya Shiba, Yusuke Hamakawa, Suguru Matsuzaka, Kazuhito Miyazaki, Yuri Taniguchi, Yuki Misumi, Yoko Agemi, Tsuneo Shimokawa, Hiroaki Okamoto
DOI: 10.1002/rcr.850

Legionnaires' disease may manifest with an acute presentation. Patients with physical risk factors could get infected without environmental risk. Early administration of antibiotics should be considered.

Motoi Yuzawa, Hiromitsu Ohta, Motoko Nomura, Kentaro Minegishi, Hisashi Oshiro, Yasuhiro Yamaguchi
DOI: 10.1002/rcr.854

This article discussed a case in which prominent lymphadenopathy with immunoglobulin G4-positive cell infiltration was caused in response to microscopic lung cancer. Surgical lymph node biopsy, as well as endobronchial ultrasound-guided transbronchial needle aspiration, could not reveal coexisting malignant cells in the mediastinal lymph node.

Kazuhide Horimoto, Yoshiro Kai, Atsuhiko Fukuoka, Shinji Tamaki, Masanori Yoshikawa, Kaoru Hamada, Shigeo Muro
DOI: 10.1002/rcr.855

Here, we report a case of diffuse aspiration bronchiolitis (DAB) with oesophageal stenosis after radiation therapy for hypopharyngeal cancer. To the best of our knowledge, this is the first report of DAB due to oesophageal stenosis after radiation therapy, highlighting the importance of late-onset chronic aspiration after radiation therapy for head and neck cancer.

Duncan J Sweeney, Maitri Munsif, David Pilcher, Rob G Stirling, Tracy L Leong
DOI: 10.1002/rcr.856

Pulmonary alveolar proteinosis is a rare disease which can be challenging to diagnose. We report the case of a 30-year-old male who developed the condition in the setting of occupational exposures and describe an unusual complication of bronchoscopy that presented management challenges.

Mai Tanimura, Nobutaka Kataoka, Yusuke Kunimatsu, Rei Tsutsumi, Izumi Sato, Takayuki Nakano, Keiko Tanimura, Takayuki Takeda
DOI: 10.1002/rcr.857

We report a patient with c-ros oncogene 1 (ROS1)-rearranged non-small cell lung cancer, who developed drug-induced interstitial lung disease 2 months after crizotinib treatment, and was sequentially treated with entrectinib, resulting in a stable disease with a marginal response.

Melanie Trishna Hui Min Roy, Chee Hong Loh, Melonie Sriranganathan, Angela Maria Takano Pena, Jagadesan Raghuram
DOI: 10.1002/rcr.859

We present a case of idiopathic recurrent serositis affecting the pleural and pericardial membranes. This is an increasingly recognized entity. We include a review of the published literature along with discussions about potential treatments.

Pei-Yee Onn, Catherina L Chang
DOI: 10.1002/rcr.860

This is a report of a case of generalized lichenoid skin eruptions and systemic inflammatory response occurring together following the first dose of the Pfizer-BioNTech vaccine. This case adds to an accumulating body of literature connecting autoimmunity with the pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Ralph Nehme, Mohamad Fleifel, Melissa Abou Khalil, Ali Al Dailaty
DOI: 10.1002/rcr.861

We report the case of a patient with a recent coronavirus disease 2019 (COVID-19) infection that got complicated by a massive pulmonary embolism as well as benign post-intubation tracheal stenosis.

Pratibha Gogia, Sandeep Attawar, Vivek Singh, Tarun Bhatnagar, Sanjay Sharma, Khushboo Batra, Swapnil Khare
DOI: 10.1002/rcr.862

This case study describes the comprehensive care of a patient with complicated COVID-19-related adult respiratory distress syndrome using clinical judgement and advanced modalities such as extracorporeal membrane oxygenation and lung transplantation (Ltx). Final outcome is favourable, asserting better defined indications for Ltx in severe COVID-19 cases.

Tzy Harn Chua, Angela Takano, Yi Ju Yao, Sau Yee Chow, Anantham Devanand, Chee Kiang Tay
DOI: 10.1002/rcr.864

We present a 33-year-old male presenting with pulmonary alveolar proteinosis (PAP) and a history of vaping. Serum anti-granulocyte-macrophage colony-stimulating factor antibodies were present. Vitamin E (VE), but not VE acetate, was detected in bronchoalveolar lavage. This is the first report of potential association between vaping and autoimmune PAP.

Hiroyuki Ishihara, Kensuke Kataoka, Reoto Takei, Yasuhiko Yamano, Toshiki Yokoyama, Toshiaki Matsuda, Tomoki Kimura, Junya Fukuoka, Takeshi Johkoh, Yasuhiro Kondoh
DOI: 10.1002/rcr.865

We report a case showing diffuse alveolar damage in a patient with rapidly progressive interstitial lung disease (RP-ILD) with anti-melanoma differentiation-associated gene 5 antibody-positive clinically amyopathic dermatomyositis, diagnosed by transbronchial lung cryobiopsy (TBLC) at an early stage without respiratory failure. Although this patient initially did not show respiratory failure, his respiratory condition gradually worsened despite intensive immunosuppression therapy and he died 3 months later. In patients with RP-ILD, TBLC has the potential to predict prognosis and treatment response by evaluating the pathological pattern.

Hirotsugu Ohkubo, Akiko Nakano, Kohei Fujita, Yoshiyuki Ozawa, Takayuki Murase, Akio Niimi
DOI: 10.1002/rcr.867

Interstitial pneumonia with autoimmune features (IPAF) was proposed to describe patients with interstitial lung disease who do not meet the classification criteria for a defined connective tissue disease. Here, we report a spontaneous improvement case of IPAF.

Toshiyuki Sumi, Yuta Nagahisa, Keigo Matsuura, Motoki Sekikawa, Yuichi Yamada, Hisashi Nakata, Hirofumi Chiba
DOI: 10.1002/rcr.868

We report two cases of severe bronchial asthma requiring systemic steroid administration while using anti-programmed death-ligand 1 (PD-L1) antibody for advanced non-small cell lung cancer. In each case, mepolizumab was introduced, resulting in discontinuation of systemic prednisolone and good control of asthma.

Po-Hao Chen, Chun-Yuan Cheng, Li-Fu Li, Chung-Chieh Yu
DOI: 10.1002/rcr.869

We report a patient with coronavirus disease 2019 (COVID-19) who was recovering following steroid treatment but experienced rebound pneumonia after the steroid was discontinued. The duration and timing of steroids are crucial to reduce the risk of prolonged systemic inflammation and rebound pneumonia.

Saori Murata, Morio Nakamura, Shinji Sasada, Keisuke Kirita, Kota Ishioka, Saeko Takahashi, Yusuke Usui, Yumi Tsuchiya, Reishi Seki
DOI: 10.1002/rcr.863

We present a case of pulmonary foreign body granuloma diagnosed by bronchoscopy in a patient with multiple lung lesions after transcatheter arterial chemoembolization for hepatocellular carcinoma.

Kohei Fujita, Norio Araki, Tadashi Mio
DOI: 10.1002/rcr.866

We experienced a case of hyperprogressive disease (HPD) in a potential metastatic thyroid tumour during immunotherapy. HPD can be life-threatening depending on where it appears, so clinicians need to be careful.