Respirology Case Reorts

Vishal Saddi, Antonia O'Connor, Ganesh Thambipillay, Arthur Teng
DOI: 10.1002/rcr2.1269

Average volume assured pressure support (AVAPS) mode enables the ventilator to deliver a constant pre-set tidal volume by automatically adjusting the inspiratory pressures within a set range. Although AVAPS mode has been available since 2009, data on its use in children are limited. We report safe and successful use of the AVAPS mode in four paediatric patients with tracheostomy ventilation.

Saquib Siddiqui, Umair Falak, Ned Frost, Waseem Athar, Muhammad Haroon Mujtaba Memon, Asma Zeeshan Qazi
DOI: 10.1002/rcr2.1285

Literature evidence on sub-cutaneous drain insertion in severe surgical emphysema is lacking. In this article, we present a retrospective analysis of a case series consisting of five patients suffering from pneumo-mediastinum and severe surgical emphysema successfully treated with subcutaneous drainage.

Theresa Schreder, Yves Borbély, Stefan Christen, Reiner Wiest, Lorenz Räber, Gunar Günther
DOI: 10.1002/rcr2.1244

We report a case of successful closure of two adjacent TEFs with two partially overlapping cardiac amplatzer occluder devices. The insertion of a 12 mm and a 9 mm device was successful and without complications. The patient tolerated the cardiac amplatzer-devices well and could resume oral food uptake after 2 months. Two years after closure, the patient remained free of symptoms suggesting complete sealing of the fistulas

Sudharsan Venkatesan, Bharti Ramnani, Sonja Klebe, Lin Mo
DOI: 10.1002/rcr2.1261

The multiple radiological changes associated with Eosinophilic Granulomatosis with Polyangiitis.

Takahiro Matsuyama, Masashi Oniwa, Kentaro Tsuruzono, Shunsuke Yasuda, Mikiko Yone, Yuya Tomioka, Akifumi Uchida, Hideo Mitsuyama, Shingo Kubota, Takayuki Suetsugu, Keiko Mizuno, Hiromasa Inoue
DOI: 10.1002/rcr2.1262

Choroidal metastasis is most commonly observed in primary breast and lung cancer. In this report, a lung cancer patient with choroidal metastasis was treated with nivolumab plus ipilimumab combined with two cycles of platinum-based chemotherapy, resulting in a reduction of the primary tumour and choroidal metastases, and an improvement of visual acuity and quality of life.

Takuya Ohashi, Mitsumasa Kawago, Hideto Iguchi, Masahiro Sakaguchi, Kanako Sagan, Fumiyoshi Kojima, Yoshiharu Nishimura
DOI: 10.1002/rcr2.1263

MPMN, which was GGN at the time of initial diagnosis, gradually developed into a substantial component during chest CT follow-up, and the GGN gradually transformed into a part-solid nodule. The imaging course described in this case is quite unique.

Hiromu Kawano, Keiko Kan-o, Ayaka Egashira, Isamu Okamoto
DOI: 10.1002/rcr2.1264

Allergic bronchopulmonary aspergillosis (ABPA) is a chronic inflammatory airway disease that develops through allergic reactions induced by the ubiquitous fungus Aspergillus fumigatus in the airways. We experienced an unusual case of unilateral high-attenuation mucus plugs and atelectasis following same side bacterial pleural empyema, which led to the diagnosis of ABPA.

Emma Jeffs, Hyukjoon Lee, Lutz Beckert
DOI: 10.1002/rcr2.1265

A 38-year old man with the anomalous pulmonary venous drainage presented with recurrent hemoptysis. Bronchial arterial embolization led to lung infarction and eventually pneumonectomy.

Takeshi Matsumoto, Yumiko Sakurai, Noriyuki Tashima, Tomoya Matoba, Akiko Kaneko, Takahiro Fujiki, Yusuke Kusakabe, Emi Nakayama, Ayaka Tanaka, Mayuko Tashima, Naoki Yamamoto, Kensaku Aihara
DOI: 10.1002/rcr2.1266

Herein, we report two cases using dual biologics for severe asthma and atopic dermatitis. A 52-year-old male patient who received dupilumab and mepolizumab, benralizumab, or tezepelumab, followed by bronchial thermoplasty, and a 41-year-old male patient who received dupilumab and omalizumab, both experienced improved asthma and atopic dermatitis. Dual biologics may be an effective treatment method for severe asthma, requiring further investigation.

Tingyu Pan, Xinyu Sun, Xiao Wu, Futing Tang, Xianmei Zhou, Qian Wang, Shi Chen
DOI: 10.1002/rcr2.1267

Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a highly aggressive, recurrent, and metastatic subtype of inflammatory myofibroblastic tumour (IMT). Here, we for the first time reported a case of mediastinal EIMS with the EML4-ALK fusion. Unfortunately, the patient died of respiratory failure due to the rapidly progressing EIMS that compressed the trachea and right main bronchus, 1 day before diagnosis.

Makoto Takahama
DOI: 10.1002/rcr2.1268

This paper should be of interest to a broad readership, particularly those in the field of thoracic surgery, because we describe the case of a 69-year-old female who was referred to our hospital after presenting with orthopnea, severe chest pain, and progressively worsening difficulty in breathing for 1 month. Radical sleeve resection of the left main bronchus was performed without sacrificing lung parenchyma via left posterolateral thoracotomy. At 5-year follow-up, no operative complications or disease recurrence were noted.

Toshiki Morimoto, Takako Kawaguchi, Kei Yamasaki, Tatsuya Shingu, Hiroaki Ikegami, Hiroki Dosaka, Yuichi Murata, Yoshinori Kawabata, Kazuhiro Yatera
DOI: 10.1002/rcr2.1273

Thrombocytopenia and anaemia are common complications of Idiopathic multicentric Castleman's disease (iMCD)-induced hematologic disorders, however, neutropenia associated with iMCD is rare. The association between iMCD and autoimmune neutropenia (AIN) involving anti-neutrophil antibodies has not yet been elucidated. Here, we present the first case report of iMCD complicated by secondary AIN with positive anti-neutrophil antibodies.

Valentin Bovy, Tom De Keukeleire, Elke Van Schoote, Inge Vanslembrouck, Anne-Marie Bogaert
DOI: 10.1002/rcr2.1274

Most of the time, a post-traumatic pleural effusion is linked by physicians to a hemothorax. A post-traumatic chylothorax is usually not considered, largely because of the uncommon nature of this condition. In this article, we present a successful conservative treatment of a patient with post-traumatic chylothorax after falling down the stairs.

Eriko Nakamura, Masahide Ota, Ryosuke Matsuda, Maiko Takeda, Tomomi Fujii, Yoshifumi Yamamoto, Shigeto Hontsu, Motoo Yamauchi, Masanori Yoshikawa, Shigeo Muro
DOI: 10.1002/rcr2.1277

Drug-induced lung injury caused by molecular-targeted agents has been reported. Medical history of interstitial lung disease and chest irradiation are established risk factors for the development and progression of drug-induced lung injury. A case of successful dabrafenib and trametinib combination therapy in a patient with BRAF V600E-mutant non-small-cell lung cancer who had a history of radiation pneumonitis and developed recurrence after conventional chemoradiotherapy is presented in this article.

Ummi Nadira Daut, Muhammad Halmii Faisal Thena, Tan Hui-Xin, Mona Zaria Nasaruddin, Jamalul Azizi Abdul Rahaman
DOI: 10.1002/rcr2.278

This case report explores the rare association between inflammatory endobronchial polyps (IEPs) and recurrent pneumothorax. The report presents the case of a 30-year-old woman who was diagnosed with IEPs obstructing the bronchi, leading to recurrent pneumothorax. The report highlights the diagnostic challenges, management strategies, and the need for further research to understand this uncommon association.

Yoshiro Kai, Ryosuke Kataoka, Kentaro Suzuki, Eriko Nakamura, Masato Takano, Shigeo Muro
DOI: 10.1002/rcr2.1279

Chronic eosinophilic pneumonia (CEP) is an eosinophilic lung disease. Treatment for CEP includes corticosteroids; however, CEP often recurs. We present a case of successful discontinuation of corticosteroids through remission induction therapy with benralizumab in a 53-year-old woman diagnosed with CEP.

Alice L Crawford, Niranjan Setty, Brooke Kyle, Kate Baumwol, John D Blakey
DOI: 10.1002/rcr2.1282

This case highlights three key points in managing difficult-to-control asthma; the importance of identifying and acting upon a discrepancy between symptom severity and objective evidence, the benefits of a structured multidisciplinary approach in improving outcomes, and the pivotal role of complex testing in the hospital outpatient setting.

Yuta Takahashi, Hiroaki Tachi, Ryo Watanabe, Kei Shimizu, Yusuke Yamamoto
DOI: 10.1002/rcr2.1284

We report a case of drug-induced lung injury treated with prior atezolizumab and subsequent sotorasib. Definitive identification of the responsible drug for the drug-induced lung injury proved challenging in the setting of exposure to multiple potential inciting agents. There is a need for high levels of clinical suspicion for timely evaluation and management.

Tzu-I Chuang, Pin-Kuei Fu
DOI: 10.1002/rcr2.1283

In this report, we present a complex case involving poorly controlled diabetes that manifested as massive hemoptysis due to invasive pulmonary aspergillosis, a consequence of chronic pulmonary aspergillosis (CPA) transformation. Interestingly, the patient's improved blood sugar control and weight gain inversely correlated with serum IgG levels for Aspergillosis. This case also illustrates the potential for non-invasive monitoring of CPA activity and identifying treatment responders through improved blood sugar management and weight gain.

Ryo Miyata, Shoichiro Morizono, Tadashi Umehara, Aya Harada-Takeda, Go Kamimura, Masaya Aoki, Toshiyuki Nagata, Kazuhiro Ueda
DOI: 10.1002/rcr2.1276

Herein, we report a case of attempted transbronchial spigot insertion for fistulous pyothorax in residual thoracic airspace after pleurectomy/decortication for malignant pleural mesothelioma. During attempted transbronchial occlusion of the responsible bronchus, some spigots penetrated the empyema cavity, and open window thoracotomy was performed on the following day.

Yuichi Nagata, Takayasu Watanabe, Yuki Tanabe, Motoyasu Kato, Takehito Shukuya, Kuniaki Seyama, Kazuhisa Takahashi
DOI: 10.1002/rcr2.1271

Extrapleural air is a rare condition that may concurrently develop with pneumomediastinum and pneumothorax, especially in older patients with fragile connective tissues. Coronal reconstruction computed tomography images help in determining how air from pneumomediastinum is related to other conditions such as extrapleural air and pneumothorax. Extrapleural air is very rare, but it should be differentiated from pneumothorax and closely monitored to prevent inadvertent harm.

Hsueh-min Yang, Fan-Chun Meng
DOI: 10.1002/rcr2.1272

We present a case of misdiagnosis of tuberculosis (TB). While TB is common in Taiwan, this case highlights the importance of differential diagnoses to avoid misdiagnosis and ensure appropriate treatment.

Louis Chhor, Reditta Soraya Tumali, Caroline Östberg, Andrew Macdonald, Christine Wade
DOI: 10.1002/rcr2.1275

Nocardia is generally regarded as an opportunistic infection, affecting immunocompromised patients but case reports have been described in immunocompetent patients. Endobronchial nocardiosis is a rare manifestation of pulmonary nocardiosis. Persistent productive cough despite appropriate treatment warrants suspicion of pulmonary nocardiosis such as in this case, which resulted in an unexpected finding of a calcified broncholithiasis secondary to Nocardia infection.

Toshiyuki Sumi, Jun Sakakibara-Konishi, Keito Suzuki, Hirofumi Chiba
DOI: 10.1002/rcr2.1280

We present a rare case of posterior interosseous nerve (PIN) palsy secondary to lung cancer metastasis.