Respirology Case Reorts

Nikko John Dalisay, Bernice Ong - dela Cruz, Percival Punzal, Ma. Encarnita Limpin
DOI: 10.1002/rcr2.1187

Here we report the outcome of nine subjects with post-acute COVID-19 symptoms (PACS) who underwent 24 sessions of supervised pulmonary telerehabilitation. An improvised telerehabilitation PR was formulated to accommodate home confinement during the pandemic. Exercise capacity and pulmonary function were assessed using a cardiopulmonary exercise test, pulmonary function test, and St. George Respiratory Questionnaire (SGRQ). The clinical outcome shows improved exercise capacity on the 6-minute walk test for all patients, and most had improvement in VO2 peak and SGRQ. Seven patients improved in forced vital capacity and six in forced expiratory volume. This case series shows the clinical impact and benefit of pulmonary telerehabilitation in a resource-limited setting.

Erik Sören Halvard Hansen, Meyya Bouazzi, Klaus Richter Larsen, Annemette Abield-Nielsen, Oli Jacob Dalsgaard, Kasper Eibye
DOI: 10.1002/rcr2.1157

We present a case of delayed complication with bilateral pneumothorax (ptx) and subcutaneous emphysema at the biopsy site following computer-tomography guided needle biopsy in a patient with a history of thymectomy. A history of thymectomy has previously been described as a cause of bilateral pneumothorax following procedures such as placement of right subclavian catheters however in such cases the onset of ptx was immediate. In our case, the patient had a normal chest x-ray 2 hours following the biopsy and the onset started 4 h after the procedure. We suggest to increase the observation phase in such patients after an endo- or transthoracic intervention with a risk of pneumothorax.

Samantha Chin-Yun Kung, Olivia Dixon, Sarah Kentwell, Raja S Vasireddy, Jonathan Rodgers, Yuming Ding, Tony Rahman, Caroline Tallis, Ian A Yang, John A Mackintosh
DOI: 10.1002/rcr2.1182

A 33-year-old man presented with acute dyspnoea and orthodeoxia. CT chest showed established pulmonary fibrosis in a usual interstitial pneumonia pattern and additional investigations revealed oesophageal varices and portal hypertensive gastropathy from liver cirrhosis. Telomere length testing demonstrated short telomeres (<1st percentile) with a gene panel identifying a pathogenic variant in TERT and a variant of uncertain significance in PARN.

Takuya Ohashi, Mitsumasa Kawago, Yoshimitsu Hirai, Yumi Yata, Aya Fusamoto, Hideto Iguchi, Takahito Nakaya, Megumi Kiyoi, Miwako Miyasaka, Mari Kawaji, Yuki Furuta, Yoshiharu Nishimura
DOI: 10.1002/rcr2.1185

Parathyroid carcinoma is rare. This is a valuable case in which the serum calcium level was controlled by surgery. The patient also developed post-operative hypocalcaemia, which should be reported.

Leping Koay, Hwei Yee Lee, Huiying Xu, Chee Kiang Phua
DOI: 10.1002/rcr2.1186

Hepatocellular carcinoma presenting with endobronchial metastases is extremely rare, with less than 15 cases reported over the last 4 decades. We describe a case of a 62-year-old male who first presented with pulmonary symptoms secondary to bilateral endobronchial metastatic disease from newly diagnosed hepatocellular carcinoma.

Audrey K Grech, Christiaan Yu
DOI: 10.1002/rcr2.1188

We present a previously undescribed occurrence of Lane-Hamilton syndrome, where there was a notable latency between abdominal and pulmonary manifestations. This resulted in a diagnostic delay and disease control was ultimately achieved through immunosuppression and a gluten free diet, highlighting the importance in achieving a timely diagnosis.

Chirine Moussa, Samia Esbaa, Houda Rouis, Nada Sellami, Meriam Hajji, Yoldez Houcine, Amel Khattab, Ibtihel Khouaja, Ines Zendah, Sonia Maâlej
DOI: 10.1002/rcr2.1190

We present a case of rifampicin-induced acute renal failure due to acute tubulointerstitial nephritis (ATIN), successfully managed with second-line anti-TB treatment.

Yukari Ichikawa, Koji Kurokawa, Shiho Furusho, Yasuto Nakatsumi, Masahide Yasui, Nobuyuki Katayama
DOI: 10.1002/rcr2.1191

Endobronchial TB (EBTB) causes bronchial stenosis; therefore, various endoscopic interventions may be required. Balloon dilatation is less invasive and has a high restenosis rate compared with the other interventions, and repeated performance is considered safe in older patients. This study presents the case of an older patient with tuberculous bronchial stenosis treated with repeated balloon dilatation to aid clinicians in persistent atelectasis and respiratory failure.

Kei Kanata, Toshihiro Shirai, Koshiro Ichijo, Masahiro Uehara
DOI: 10.1002/rcr2.1192

A 63-year-old woman with refractory atopic dermatitis developed a cough 4 days later, sputum, and a slight fever 2 weeks later. Chest x-ray and computed tomography scan showed infiltrative shadows with surrounding consolidation of both upper lobes. Bronchoalveolar lavage fluid eosinophil count was increased (50.0%), and histopathological findings were consistent with numerous eosinophilic infiltrations.

Ryosuke Imai, Atsushi Kitamura
DOI: 10.1002/rcr2.1196

Atezolizumab was administered to a patient diagnosed with LCNEC who was concurrently undergoing haemodialysis. The patient achieved partial response while receiving atezolizumab alone, indicating its sustained efficacy for a duration of 7 months. Atezolizumab can be administered safely in patients undergoing dialysis and is a promising therapeutic option for dialysis patients with LCNEC.

Isana Katayama, Arisa Komatsu, Takayasu Watanabe, Daisuke Hayakawa, Naoko Iwakami, Takuya Genda, Shin-ichiro Iwakami, Kazuhisa Takahashi
DOI: 10.1002/rcr2.1195

Mediastinal pancreatic pseudocysts are rare complications of pancreatitis associated with alcohol consumption. Here, we report a case of mediastinal pancreatic pseudocyst in a patient who presented with black pleural fluid with a high amylase level.

Lily Kou, Nai-Chien Huan, Larry Ellee Nyanti, Jiunn Sheng Chin, Nor Bahiyyah Mohamad, Hema Yamini Ramarmuty
DOI: Andika Chandra Putra, Bernadina Chyntia, Emon Winardi, Maisie Johan, Albertus Ardian Pradwiyanto, Renaningtyas Tambun, Wiwien Heru Wiyono, Fahmi Alatas
DOI: 10.1002/rcr2.1199

This case study explores primary pulmonary amoebiasis, which is a very uncommon condition. The chest imaging showed consolidation that mimicked the tumour, despite the histological analysis identifying the trophozoites or cysts of Entamoeba histolytica. Pulmonary amoebiasis is treatable with medicines and drainage if necessary. A multidisciplinary approach and appropriate therapy management are needed to decrease mortality and morbidity.

Asmita A Mehta, Aditya Ashok, Nithya Haridas, Akhilesh Kunoor, Jyotsana Yesodharan
DOI: 10.1002/rcr2.1189

We present an interesting case of a 55 year old man who presented with history of weight loss, cough and right sided chest pain. CT showed right upper lobe cavity. He was evaluated with possibility of TB, malignancy or vasculitis. Fibreoptic bronchoscopy was done that showed a ‘stony cave’ trachea. Histopathology confirmed the diagnosis to be ‘Tracheobronchopathia osteochondroplastica (TO)’. He was treated with antibiotics for his infection with total resolution of chest sahdows. He is managed conservatively for his TO.

Masaaki Iwabayashi, Rika Hashimoto, Mariko Takada, Hiromi Tomioka
DOI: 10.1002/rcr2.1194

We present a case of a male patient with a strikingly asymmetric unilateral eosinophilic pneumonia. The exact trigger for this condition remains unknown, although the patient's previous lung lobectomy may have played a role in the underlying pathophysiology.

Kei Yamasaki, Taiki Manabe, Yuto Iwanaga, Ryota Akaike, Toshinori Kawanami, Kazuhiro Yatera
DOI: 10.1002/rcr2.1198

While rare, a diagnosis of Bell's palsy should be considered in young patients who test positive for SARS-CoV-2 infection and who also present with notable neurological facial signs and symptoms suggestive of lower motor neuron-type seventh cranial nerve palsy.