Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10316/109718 https://doi.org/10.1186/1756-0500-6-S1-S1 |
Resumo: | Background: The diagnosis of idiopathic pulmonary fibrosis can be quite challenging, even after careful clinical evaluation, imaging and pathological tests. This case report intends to demonstrate and discuss these difficulties, especially those concerning the differential diagnosis with chronic hypersensitivity pneumonitis. Case presentation: A 58-year-old white male presented with shortness of breath, dry cough, fatigue and weight loss for two months. He was a former smoker and had regular exposure to a parakeet and poultry. Physical examination revealed bilateral basal crackles and chest imaging showed subpleural cystic lesions and traction bronchiectasis with a right side and upper level predominance. Auto-antibodies and IgG immunoglobulins to parakeet and fungal proteins were negative. Lung function tests displayed moderate restriction, low diffusion capacity and resting hypoxaemia. Bronchoalveolar lavage showed increased lymphocytes (28%) and neutrophils (12%) and surgical lung biopsy was compatible with a pattern of usual interstitial pneumonia. According to the possibility of either idiopathic pulmonary fibrosis or chronic hypersensitivity pneumonitis, treatment included prednisolone, azathioprine, acetylcysteine and avoidance of contact with the parakeet, but there was an unfavorable response and the patient was subsequently referred for lung transplant. Conclusion: Chronic hypersensitivity pneumonitis and idiopathic pulmonary fibrosis can present with the same clinical and radiological manifestations In this case, despite careful evaluation, no definite diagnosis could be achieved. |
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Clinical case: Differential diagnosis of idiopathic pulmonary fibrosisAcetylcysteineAlveolitis, Extrinsic AllergicAzathioprineDiagnosis, DifferentialHumansHypertension, PulmonaryIdiopathic Pulmonary FibrosisLungMaleMiddle AgedPrednisolonePulmonary EmphysemaRadiographySmokingDisease ManagementBackground: The diagnosis of idiopathic pulmonary fibrosis can be quite challenging, even after careful clinical evaluation, imaging and pathological tests. This case report intends to demonstrate and discuss these difficulties, especially those concerning the differential diagnosis with chronic hypersensitivity pneumonitis. Case presentation: A 58-year-old white male presented with shortness of breath, dry cough, fatigue and weight loss for two months. He was a former smoker and had regular exposure to a parakeet and poultry. Physical examination revealed bilateral basal crackles and chest imaging showed subpleural cystic lesions and traction bronchiectasis with a right side and upper level predominance. Auto-antibodies and IgG immunoglobulins to parakeet and fungal proteins were negative. Lung function tests displayed moderate restriction, low diffusion capacity and resting hypoxaemia. Bronchoalveolar lavage showed increased lymphocytes (28%) and neutrophils (12%) and surgical lung biopsy was compatible with a pattern of usual interstitial pneumonia. According to the possibility of either idiopathic pulmonary fibrosis or chronic hypersensitivity pneumonitis, treatment included prednisolone, azathioprine, acetylcysteine and avoidance of contact with the parakeet, but there was an unfavorable response and the patient was subsequently referred for lung transplant. Conclusion: Chronic hypersensitivity pneumonitis and idiopathic pulmonary fibrosis can present with the same clinical and radiological manifestations In this case, despite careful evaluation, no definite diagnosis could be achieved.Springer Nature2013info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10316/109718http://hdl.handle.net/10316/109718https://doi.org/10.1186/1756-0500-6-S1-S1eng1756-0500Cordeiro, Carlos RobaloAlfaro, Tiago M.Freitas, Sarainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-24T09:37:38Zoai:estudogeral.uc.pt:10316/109718Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:25:52.281291Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis |
title |
Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis |
spellingShingle |
Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis Cordeiro, Carlos Robalo Acetylcysteine Alveolitis, Extrinsic Allergic Azathioprine Diagnosis, Differential Humans Hypertension, Pulmonary Idiopathic Pulmonary Fibrosis Lung Male Middle Aged Prednisolone Pulmonary Emphysema Radiography Smoking Disease Management |
title_short |
Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis |
title_full |
Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis |
title_fullStr |
Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis |
title_full_unstemmed |
Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis |
title_sort |
Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis |
author |
Cordeiro, Carlos Robalo |
author_facet |
Cordeiro, Carlos Robalo Alfaro, Tiago M. Freitas, Sara |
author_role |
author |
author2 |
Alfaro, Tiago M. Freitas, Sara |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Cordeiro, Carlos Robalo Alfaro, Tiago M. Freitas, Sara |
dc.subject.por.fl_str_mv |
Acetylcysteine Alveolitis, Extrinsic Allergic Azathioprine Diagnosis, Differential Humans Hypertension, Pulmonary Idiopathic Pulmonary Fibrosis Lung Male Middle Aged Prednisolone Pulmonary Emphysema Radiography Smoking Disease Management |
topic |
Acetylcysteine Alveolitis, Extrinsic Allergic Azathioprine Diagnosis, Differential Humans Hypertension, Pulmonary Idiopathic Pulmonary Fibrosis Lung Male Middle Aged Prednisolone Pulmonary Emphysema Radiography Smoking Disease Management |
description |
Background: The diagnosis of idiopathic pulmonary fibrosis can be quite challenging, even after careful clinical evaluation, imaging and pathological tests. This case report intends to demonstrate and discuss these difficulties, especially those concerning the differential diagnosis with chronic hypersensitivity pneumonitis. Case presentation: A 58-year-old white male presented with shortness of breath, dry cough, fatigue and weight loss for two months. He was a former smoker and had regular exposure to a parakeet and poultry. Physical examination revealed bilateral basal crackles and chest imaging showed subpleural cystic lesions and traction bronchiectasis with a right side and upper level predominance. Auto-antibodies and IgG immunoglobulins to parakeet and fungal proteins were negative. Lung function tests displayed moderate restriction, low diffusion capacity and resting hypoxaemia. Bronchoalveolar lavage showed increased lymphocytes (28%) and neutrophils (12%) and surgical lung biopsy was compatible with a pattern of usual interstitial pneumonia. According to the possibility of either idiopathic pulmonary fibrosis or chronic hypersensitivity pneumonitis, treatment included prednisolone, azathioprine, acetylcysteine and avoidance of contact with the parakeet, but there was an unfavorable response and the patient was subsequently referred for lung transplant. Conclusion: Chronic hypersensitivity pneumonitis and idiopathic pulmonary fibrosis can present with the same clinical and radiological manifestations In this case, despite careful evaluation, no definite diagnosis could be achieved. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10316/109718 http://hdl.handle.net/10316/109718 https://doi.org/10.1186/1756-0500-6-S1-S1 |
url |
http://hdl.handle.net/10316/109718 https://doi.org/10.1186/1756-0500-6-S1-S1 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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1756-0500 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Springer Nature |
publisher.none.fl_str_mv |
Springer Nature |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799134140267757568 |