scholarly journals Endobronchial Watanabe spigot complementing prophylactic balloon blocker in the management of post-transbronchial cryobiopsy bleeding

2021 ◽  
pp. 201010582110194
Author(s):  
Larry Ellee Nyanti ◽  
Sze Shyang Kho ◽  
Swee Kim Chan ◽  
Chan Sin Chai ◽  
Siew Teck Tie
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Bronchial Artery ◽  
Middle Lobe ◽  
Definitive Method ◽  
Life Threatening ◽  
Right Middle Lobe ◽  
Bronchial Artery Embolisation ◽  
Definitive Management

Transbronchial cryobiopsy (TBCB) is performed to aid diagnosis of interstitial lung disease, of which bleeding is a potentially life-threatening complication. Post-TBCB management involves temporary balloon blockade, bronchial artery embolisation (BAE) or surgery. Bronchial occlusion by endobronchial Watanabe spigot (EWS) as the definitive method of bleeding control post TBCB has not been described. A 56-year-old male underwent TBCB to aid diagnosis of interstitial lung disease. TBCB had been performed at RB4 (lateral segment of right middle lobe) with a prophylactic balloon blocker. However, prolonged bleeding was observed upon deflation of the balloon blocker. Haemostasis was secured with successful deployment of EWS into RB4, with no evidence of rebleeding in surveillance bronchoscopy and chest radiographs. EWS was kept in situ for four days and subsequently removed. The patient was discharged with good functional status. This case demonstrates that EWS placement may be considered for definitive management of low-volume post-TBCB bleeding, especially when BAE and surgical intervention are not possible.

Endovascular Treatment of Multiple Bronchial Artery Aneurysms With Prominent Fistula to Pulmonary Artery in a Patient With Interstitial Lung Disease: A Case Report and Literature Review

2019 ◽  
Vol 53 (6) ◽  
pp. 492-496
Author(s):  
Yuan Li ◽  
Guang-Chao Gu ◽  
Bao Liu ◽  
Jiang Shao ◽  
Yu Chen ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Bronchial Artery ◽  
Pulmonary Arteries ◽  
Artery Aneurysm ◽  
Transcatheter Embolization ◽  
Life Threatening ◽  
Nontarget Embolization ◽  
Feeding Vessels ◽  
The Right

Bronchial artery aneurysm (BAA) is a rare entity. Ruptured BAA can cause life-threatening hemorrhage. It is recommended that treatment should be initiated immediately after diagnosis. We present the case of a 56-year-old female with multiple BAAs and interstitial lung disease. Aortic computed tomography angiography demonstrated that the largest aneurysm at the right hilum was fed by right subclavian artery and right bronchial artery. A fistula between the pulmonary trunk and the aneurysm was also revealed. The patient underwent transcatheter embolization. Coils were placed in the feeding vessels instead of the aneurysms to avoid nontarget embolization of the pulmonary arteries through the fistula. The procedure achieved reduction in aneurysmal blood flow. The patient’s cough resolved at 6-month follow-up.

scholarly journals Fast-Onset Diffuse Interstitial Lung Disease in Anti-MDA5 Antibodies-Associated Amyopathic Dermatomyositis

2021 ◽  
Vol 11 (2) ◽  
pp. 235-240
Author(s):  
Houari Aissaoui ◽  
Kinan Drak Alsibai ◽  
Naji Khayath
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Distress Syndrome ◽  
Early Stage ◽  
Immunosuppressive Treatment ◽  
Amyopathic Dermatomyositis ◽  
Pulmonary Manifestations ◽  
Life Threatening ◽  
Adequate Management ◽  
Chest Ct Scan

Anti-MDA5 antibodies-associated amyopathic dermatomyositisis a rare autoimmune disease that involve polyarthritis, cutaneous and pulmonary manifestations. The development of rapidly progressing interstitial lung disease is a life-threatening complication. We report the case of a 45-year-old woman without medical history, who was addressed to the Pulmonary Department for a polyarthritis with dry cough and hypoxemic dyspnea. Initially there was neither cutaneous manifestation nor interstitial lung disease on chest CT scan. After a few days, the patient developed fatal acute respiratory failure with diffuse ground glass opacities. Identification of anti-MDA5 antibodies allowed establishing diagnosis, despite the fact that the first immunological assessment was negative. Corticosteroid bolus of 1 g for three days and immunosuppressive treatment by cyclophosphamide was only initiated at the acute respiratory distress syndrome stage. Given the rapidly unfavorable prognosis of this entity of amyopathic dermatomyositis, the testing for anti-MDA5 antibodies should be recommended in case of progressive pulmonary symptoms associated with joint signs in order to identify this disease at an early stage and to begin rapid and adequate management.

scholarly journals Bi-lung transplantation in anti-synthetase syndrome with life-threatening interstitial lung disease

Rheumatology ◽  
2018 ◽  
Vol 57 (9) ◽  
pp. 1688-1689 ◽  
Author(s):  
Marion Delplanque ◽  
Marc Gatfosse ◽  
Hafid Ait-Oufella ◽  
Olaf Mercier ◽  
Laurent Savale ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Transplantation ◽  
Lung Disease ◽  
Life Threatening

scholarly journals Change in serum KL-6 level from baseline is useful for predicting life-threatening EGFR-TKIs induced interstitial lung disease

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Shigeo Kawase ◽  
Noboru Hattori ◽  
Nobuhisa Ishikawa ◽  
Yasushi Horimasu ◽  
Kazunori Fujitaka ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Life Threatening ◽  
Egfr Tkis

Lingular and Right Middle Lobe Biopsy in the Assessment of Diffuse Lung Disease

1987 ◽  
Vol 44 (3) ◽  
pp. 269-273 ◽  
Author(s):  
Roberta R. Miller ◽  
Bill Nelems ◽  
Nestor L. Müller ◽  
Kenneth G. Evans ◽  
David N. Ostrow
Keyword(s):  
Lung Disease ◽  
Middle Lobe ◽  
Diffuse Lung Disease ◽  
Right Middle Lobe ◽  
Diffuse Lung

Life-threatening interstitial lung disease associated with trastuzumab: case report

2008 ◽  
Vol 113 (3) ◽  
pp. 609-612 ◽  
Author(s):  
M. J. Pepels ◽  
K. A. Boomars ◽  
R. van Kimmenade ◽  
P. S. Hupperets
Keyword(s):  
Case Report ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Life Threatening

scholarly journals Fatal congenital lobar emphysema in a puerpera: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanyi Gan ◽  
Liang Xia ◽  
Yushang Yang ◽  
Qiang Pu ◽  
Lunxu Liu
Keyword(s):  
Left Lung ◽  
Middle Lobe ◽  
Left Hemithorax ◽  
Recurrent Pneumonia ◽  
Mediastinal Shift ◽  
Life Threatening ◽  
Right Middle Lobe ◽  
Lobar Emphysema ◽  
The Right

Abstract Background Congenital lobal emphysema (CLE) is a developmental lung abnormality usually diagnosed in the neonatal period and is rarely observed in adults. Adults with CLE are usually asymptomatic and only a small fraction may present with coughing, recurrent pneumonia and respiratory distress. In imaging studies, the most frequently affected lobe of CLE is the left upper lobe, followed by the right middle lobe. However, multilobar involvement with severe mediastinal shift is extremely rare. Case presentation We report a case of fatal CLE in a 28-year-old puerpera with postpartum respiratory failure. Chest computed tomography (CT) revealed emphysema of the right upper, middle and lower lobes resulting in adjacent atelectasis. Hyperinflation of the right upper lobe crossed the midline, leading to a deviation of the mediastinal structure to the left hemithorax and severe compression of the left lung. Conclusions Early and timely diagnosis of CLE with routine follow-up is necessary for patients. CLE, especially with multilobar involvement or mediastinal shift, could be life-threatening and should be promptly and aggressively treated to prevent severe complications.

scholarly journals Pre-existing interstitial lung disease is associated with onset of nivolumab-induced pneumonitis in patients with solid tumors: A retrospective analysis

2019 ◽  
Author(s):  
Teppei Yamaguchi ◽  
Junichi Shimizu ◽  
Takaaki Hasegawa ◽  
Yoshitsugu Horio ◽  
Yoshitaka Inaba ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Solid Tumors ◽  
Odds Ratio ◽  
Malignant Tumors ◽  
Checkpoint Inhibitors ◽  
Patient Characteristics ◽  
Chest Ct ◽  
Life Threatening ◽  
Male Sex

Abstract BackgroundNivolumab, an anti-programmed death 1 (PD-1) monoclonal antibody, has shown survival benefit in clinical trials of various malignant tumors. Nivolumab-induced pneumonitis is major immune-related adverse event (irAE) that is occasionally serious and life-threatening. The aim of this study was to examine the association between pre-existing interstitial lung disease (ILD) on chest computed tomography (CT) and nivolumab-induced pneumonitis among different types of solid tumors.MethodsWe retrospectively collected the clinical data of 311 patients who were diagnosed with non-small cell lung cancer (NSCLC), head and neck cancer (HNC), or gastric cancer (GC), and treated with nivolumab monotherapy. Patients who underwent chest CT immediately before starting nivolumab without previous thoracic radiotherapy or other immune checkpoint inhibitors were eligible. We collected baseline patient characteristics and assessed pre-existing ILD on baseline chest CT.ResultsFinally, 188 patients were included in the analysis: 96 patients with NSCLC, 43 patients with HNC, and 49 patients with GC. NSCLC patients had a significantly higher rate of pre-existing ILD compared with HNC/GC patients (P=0.047). Nivolumab-induced pneumonitis occurred in 11.7% (22 of 188), including 14.6% (14 of 96) of NSCLC, and 8.7% (8 of 92) of HNC/GC. Univariate and multivariate logistic regression analyses revealed that pre-existing ILD (odds ratio, 5.92; 95% confidence interval (CI), 2.07–18.54, P=0.0008) and male sex (odds ratio, 5.58; 95% CI, 1.01–104.40, P=0.049) significantly increased the risk of nivolumab-induced pneumonitis.ConclusionOur results indicated that pre-existing ILD and male sex are risk factors for nivolumab-induced pneumonitis in solid tumors.

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