Eosinophilic lung disease - chronic

Case contributed by Dr Lawrence Josey

Presentation

Acute exacerbation of asthma, requiring hospitalisation.

Patient Data

Age: 55
Gender: Female

HRCT as workup for pulmonary fidings on chest X-ray.

There are bilateral predominantly peripheral patchy regions of ground-glass opacification within the lungs. No subpleural sparing. There is bilateral traction bronchiectasis with bronchial wall thickening in the parahilar regions extending to the lower lobes. No air trapping on the expiratory images (Not provided). Cavitary lesions noted.

Mediastinal lymphadenopathy measures up to 1.4cm in the precarinal region as well as in the anterior mediastinum. Main pulmonary trunk calibre is increased at 32mm.

Case Discussion

Pt was admitted to respiratory ward. (FEV1: 0.58, 27% - FVC: 0.8L, 35% - DLCO: 8.4, 39%)
Treated with regular Salbutamol Nebs and physiotherapy.
Atypical serology was negative.
Sputum M.C.S was negative
Oral steroids (Pred started at 50mg and weaned to 25mg)
The patient had pulse IV Methylpred for consecutive three days before discharge.
Pt was commenced on Azathiprine 50mg which she will be maintained on for a period of time with steroids.
Bone scan was performed which confirmed osteoporosis

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Case information

rID: 18019
Case created: 1st Jun 2012
Last edited: 16th Jul 2017
System: Chest
Inclusion in quiz mode: Included

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