Respirology Case Reorts

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January 2023
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Case Series
Pre and post-COVID 19 infection pulmonary functions in children with chronic respiratory disease: A case series
Salim Ramadan, The Thanh Diem Nguyen, Sophie Laberge, Jacques-Edouard Marcotte, Zofia Zisman-Colman, Sze Man Tse
DOI: 10.1002/rcr2.1077

Data on post-COVID functional respiratory impairment in children are scarce. Children with chronic lung disease are not at increased risk for severe COVID. No or only transient functional respiratory impairment post-COVID is observed in these children.

Case Reports
Massive iliopsoas haematoma during the course of COVID-19 pneumonia
Hiroaki Nagano, Sara Takaesu
DOI: 10.1002/rcr2.1070

This report presents a case of life-threatening iliopsoas haematoma in an immunosuppressed 86-year-old man with a history of prostate cancer during the clinical course of coronavirus disease 2019 (COVID-19).

A left pulmonary artery sling with left bronchiectasis in an adult patient: A case report and review of literature
Lin Lv, Xue Cheng, Xiaohui Yu, Chen Cui, Wenwen Ji, Na Wang, Tingting Li, Jia Liu, Zhihong Shi
DOI: 10.1002/rcr2.1072

We report a 55-year-old woman with left pulmonary artery sling and left lung bronchiectasis, performing as persistent shortness of breath, coronary computed tomography angiography (CTA) showed the aberrant left pulmonary artery emerging from the right pulmonary artery and crossing to the left between the trachea and esophagus. We experienced a rare adult case with LPAS and left bronchiectasis, stressing the importance of the anatomic abnormalities in such cases.

Isolated unilateral absence of pulmonary artery (IUAPA) in adults: A case series and review of literature
Yi Jia Loo, Rajesh Thomas, Lokesh Yagnik
DOI: 10.1002/rcr2.1073

IUAPA is a rare anatomical anomaly with vast majority of patients remaining to be asymptomatic to adulthood leading to delay in diagnosis. The severity of disease as well as rate of complication varies among patients. We present two cases with contrasting trajectories and management outcomes.

Successful treatment with dupilumab for mucus plugs in severe asthma
Moriyasu Anai, Chieko Yoshida, Hiroki Izumi, Kei Muramoto, Koichi Saruwatari, Yusuke Tomita, Hidenori Ichiyasu, Takuro Sakagami
DOI: 10.1002/rcr2.1074

We report a case of severe asthma in which the introduction of dupilumab improved the mucus plugs in addition to asthma control.

Diagnosis of pulmonary leiomyosarcoma extending into the main bronchus using repeated transbronchial cryobiopsy
Shinya Tsukamoto, Takamasa Kitajima, Satoshi Marumo, Motonari Fukui
DOI: 10.1002/rcr2.1078

Pulmonary leiomyosarcoma is a rare tumour. Diagnosis by bronchoscopy is difficult because of significant necrotic tissue in the tumour and laborious exfoliation of the cells. We report a case of pulmonary leiomyosarcoma, successfully diagnosed using repeated transbronchial cryobiopsy (TBCB).

Non-pulmonary CFTR-related symptom improvement with ivacaftor in p.Phe508del/p.Arg117His (7T) cystic fibrosis
Stephanie L Kuek, R John H Massie
DOI: 10.1002/rcr2.1079

We describe the case of an 18-year-old patient with cystic fibrosis who has had minimal lung disease but significant improvement in chronic sinusitis and recurrent pancreatitis following commencement of ivacaftor. We discuss the ongoing challenges in diagnosis and management of CRMS/CFSPID infants and those with milder phenotypes, with particular reference to the emerging significance of CFTR modulators. We suggest that there may be a role for expanding the usual pulmonary indications of CFTR modulators in some cases.

Clinical images
Atypical negative pressure pulmonary edema after extracorporeal membrane oxygenation therapy for COVID-19
Yu Suzuki, Takaaki Ogoshi, Yusuke Taura, Shiori Oda, Daiji Uchiyama, Hiroyuki Ueda, Kazuhiro Yatera
DOI: 10.1002/rcr2.1071

Atypical negative pressure pulmonary edema showing a peripheral accent pattern resembling ARDS has emerged after COVID-19 pneumonia four months ago. Capillary damage from COVID-19 might still exist.

Large lung mass lesion with spontaneous regression in a patient with IgG4-related lung disease
Kazuhiko Iwasaki, Tomoyuki Araya, Toshiyuki Kita, Tamami Sakai
DOI: 10.1002/rcr2.1075

IgG4-related lung disease (IgG4-RLD) may present with a variety of radiological findings, but large lung mass lesion are rare. Although steroid therapy is strongly recommended for IgG4-RLD with or without symptoms, respirologists should be aware that some patients may not need steroid therapy.

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