A Woman with Asthma and Peripheral Ground-Glass Opacities.
Chia-Yu ChiuMichael DavidAya MusaMohmed GoraManmeet Kaur GujralPublished in: Case reports in pulmonology (2019)
Eosinophilic lung disease is a heterogeneous group of disorders that reveal eosinophil involved lung tissue often in patients with asthma or atopy. Classification and diagnostic criteria of eosinophilic lung disease are not well-established; however, peripheral ground-glass opacity is typical on chest computed tomography. Another etiology of this same radiographic finding reported in the literature is silicone embolism syndrome. Here, we present a 43-year-old female with poorly controlled severe persistent asthma presenting with difficulty breathing. Computed tomography showed peripherally dominant ground-glass opacity. Peripheral blood, bronchoalveolar lavage fluid analysis, and transbronchial biopsy did not find eosinophilia. Serial bronchoalveolar lavage of the demonstrated increasingly blood-tinged fluid. The patient required mechanical ventilation upon admission. After further questioning the patient revealed that she had frequently received injectable cosmetics at non-licensed establishments. Initially, due to past medical history, presentation, and radiographic findings, eosinophilic pneumonia was suspected. However, after a review of the patient's social history and risk factors, silicone embolisms syndrome became a likely diagnosis. The patient had good clinical response to high dose steroid therapy.
Keyphrases
- case report
- computed tomography
- chronic obstructive pulmonary disease
- mechanical ventilation
- high dose
- risk factors
- peripheral blood
- lung function
- healthcare
- emergency department
- positron emission tomography
- systematic review
- intensive care unit
- magnetic resonance imaging
- allergic rhinitis
- acute respiratory distress syndrome
- gene expression
- single cell
- low dose
- stem cells
- ultrasound guided
- bone marrow
- deep learning
- early onset
- air pollution
- genome wide
- magnetic resonance
- smoking cessation