Respiratory medicine case reports
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Respir Med Case Rep · Jan 2018
Case ReportsMiliary tuberculosis mimicking systemic lupus erythematosus flare.
A 26-year-old woman was diagnosed with and treated for systemic lupus erythematosus (SLE) in 2002. She was admitted 11 years later with nephrotic-range proteinuria and lupus nephritis and received two doses of rituximab after failing on steroids and mycophenolate mofetil. Four months later, she presented with fever and joint pain/swelling. ⋯ Synovial fluid Smears, and cultures yielded positive results for Mycobacterium tuberculosis; similarly, sputum polymerase chain reaction test and culture confirmed pulmonary tuberculosis. Tuberculosis is difficult to diagnose in SLE patients; it may present like or precipitate SLE flare. In this patient a presumed SLE flare turned out to be an aggressive miliary, disseminated tuberculosis.
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Respir Med Case Rep · Jan 2018
Case ReportsCement pulmonary embolism after percutaneous vertebroplasty in a patient with cushing's syndrome: A case report.
Vertebroplasty is a procedure most commonly used for vertebral compression fractures. Although it is a relatively safe procedure, complications have been reported. Cement embolism is seen in 2.1%-26% of patients after percutaneous vertebroplasty. ⋯ in patients with pulmonary cement embolism, conservative treatment may be recommended rather than a surgical removal except when the obstruction is extensive enough to cause hemodynamic changes. Given that all the related studies have suggested that pulmonary thromboembolism can occur as a complication due to bone cement leakage, discovering new cement alternatives and/or injection devices, seems beneficial.
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Respir Med Case Rep · Jan 2018
Case ReportsAcute respiratory distress syndrome after the use of gadolinium contrast agent.
Acute respiratory distress syndrome (ARDS) is a life-threatening medical emergency. The etiology of ARDS can involve various causes. ARDS associated with the use of iodinated contrast media is rarely reported, and the literature includes only one case of ARDS due to gadobutrol. ⋯ She was treated for anaphylaxis, then immediately evaluated using chest x-ray and arterial blood gas analysis. Based on the findings, she was diagnosed with ARDS and started on continuous positive airway pressure (CPAP) ventilatory support and methylprednisolone at a dose of 1 mg/kg/day. On day 3 of follow-up, all symptoms had completely regressed.