Chest
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An 11-month-old boy was admitted to our hospital because of "recurrent cough with intermittent dyspnea for more than 8 months, aggravated for 1 month." The baby began experiencing a recurrent milk-choking problem within 1.5 months after birth. He had been hospitalized four times, but the symptoms recurred. ⋯ Pediatric bronchoscopy revealed bronchial inflammatory features, with hemosiderin-laden macrophages being found in BAL fluid (BALF). Also, periodic acid-Schiff (PAS) staining showed positive results, which indicated the possibility of pulmonary alveolar proteinosis (PAP) or idiopathic pulmonary hemosiderosis (IPH).
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A 68-year-old woman presented to a subspecialty complex-airways-disease clinic with chronic cough. She had a 10-pack-year history of smoking, quit over 35 years ago, and had mild atopy (dust mite) and mild rhinitis. She did not have any relevant occupational exposure or comorbidities. ⋯ It had been present for years, though it changed in nature over time. She also reported one to two episodes of streaky hemoptysis. She had not noticed significant benefit with nasal or inhaled corticosteroids, but short bursts of prednisone had temporarily modestly improved her cough.
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A 43-year-old woman without significant medical history was admitted with fatigue for 2 months. Before her current presentation, she had experienced several weeks of heavy menstrual bleeding and easy bruising. ⋯ The patient admitted a 20-year half-pack per day smoking habit that she had not been able to quit. She denied significant occupational or environmental exposures, a family history of malignancy, or current use of medications.