Respiratory medicine case reports
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Respir Med Case Rep · Jan 2020
Case ReportsSARS-CoV2 induced pulmonary embolism and complications from anticoagulation.
Coronavirus disease (COVID-19) pandemic has rapidly spread around the world. As new complications associated with the virus become more apparent, concerns in the medical community continue to grow. One of the more commonly encountered and more troubling complications in critically ill patients has been hypercoagulable state and subsequent thrombotic events. ⋯ Literature review suggests that pulmonary clot burden in COVID-19 patients could be due to pulmonary thrombus rather than pulmonary embolism and is triggered by profuse vascular damage and severe inflammatory response. Literature review also proposes changes to the diagnostic work up in COVID-19 patients, such as earlier screening for pulmonary embolism in critically ill. In addition, rare and severe complications of current anticoagulation therapy is illustrated and discussed through one of the cases presented.
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Respir Med Case Rep · Jan 2020
Case ReportsAcute Respiratory Distress Syndrome in a pregnant patient with COVID-19 improved after delivery: A case report and brief review.
Acute Respiratory Distress Syndrome (ARDS) can frequently occur as a complication of Coronavirus Disease 19 (COVID-19). As the number of COVID-19 cases increases around the world, it is inevitable that COVID-19 and ARDS will complicate some pregnancies. Currently, there is scant data to guide decision-making on the timing of delivery for these patients. We present the case of a 41-year-old patient with severe ARDS from COVID-19 who was also 32 weeks pregnant, whose respiratory status improved dramatically after delivery.
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Respir Med Case Rep · Jan 2020
Case ReportsEfficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases.
Infection with COVID-19 potentially can result in severe outcomes and death from "cytokine storm syndrome", resulting in novel coronavirus pneumonia (NCP) with severe dyspnea, acute respiratory distress syndrome (ARDS), fulminant myocarditis and multiorgan dysfunction with or without disseminated intravascular coagulation. No published treatment to date has been shown to adequately control the inflammation and respiratory symptoms associated with COVID-19, apart from oxygen therapy and assisted ventilation. We evaluated the effects of using high dose oral and/or IV glutathione in the treatment of 2 patients with dyspnea secondary to COVID-19 pneumonia. ⋯ Oral and IV glutathione, glutathione precursors (N-acetyl-cysteine) and alpha lipoic acid may represent a novel treatment approach for blocking NF-κB and addressing "cytokine storm syndrome" and respiratory distress in patients with COVID-19 pneumonia.
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Respir Med Case Rep · Jan 2020
Case ReportsA case of acute progressive diffuse interstitial lung disease preceding idiopathic multicentric Castleman disease.
It has been considered that idiopathic multicentric Castleman disease often involves pulmonary complications recognized as lymphocytic interstitial pneumonia. On the other hand, recent reports show that the computed tomography often show diffuse interstitial lung disease inconsistence with lymphocytic interstitial pneumonia. Pulmonary diseases with idiopathic multicentric Castleman disease are still rare and poorly understood. ⋯ Treatment with prednisolone improved the dyspnea, and the pulmonary lesions disappeared. The presented case suggests that interstitial lung disease could precede idiopathic multicentric Castleman disease. Chest physicians should be aware that idiopathic multicentric Castleman disease is one of the causative diseases of diffuse interstitial lung disease like non-specific interstitial pneumonia on the chest images.
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Respir Med Case Rep · Jan 2020
Case ReportsRecurrence of emphysema post-lung transplantation in a patient with alpha 1 antitrypsin deficiency (AATD).
The genetic disorder alpha 1 antitrypsin deficiency (AATD) results in reduced levels of alpha 1 antitrypsin (AAT) in the lung and an imbalance between AAT anti-protease activity and the activity of proteases that degrade elastin and connective tissues. This imbalance commonly leads to the excessive proteolysis of structural tissue of the alveoli, causing chronic obstructive pulmonary disease (COPD)/emphysema. ⋯ Recurrence of COPD/emphysema was observed in a patient with AATD 2 years after initial successful lung transplantation and cessation of AAT therapy who recommenced smoking after no signs of disease at the 1-year assessment. This case demonstrates that smoking cessation is critical in patients with AATD, even after lung transplant, and it highlights that patients with AATD may benefit from AAT therapy post-lung transplant.