Presentation
Acute exacerbation of asthma, requiring hospitalization.
Patient Data
HRCT as workup for pulmonary fidings on chest X-ray.
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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 caliber is increased at 32mm.
Case Discussion
Patient was admitted to respiratory ward. (FEV1: 0.58, 27% - FVC: 0.8L, 35% - DLCO: 8.4, 39%)
Treated with regular Albuterol nebulisation and physiotherapy.
Atypical serology was negative.
Sputum M.C.S was negative
Oral steroids (Prednisolone started at 50mg and weaned to 25mg)
The patient had pulse IV Methylprednison for consecutive three days before discharge.
Patient 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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