Fibrotic Sarcoidosis Mimics Non-specific Interstitial Pneumonia: A Case Report
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2017, Vol 21, Issue 11
Abstract
Aims: Fibrotic sarcoidosis is not common presentation and it is not easy to diagnose for many differential diagnosis. We herein report an interesting fibrotic sarcoidosis who shows atypical presentation such as progressive dyspnea with fibrotic imaging findings. Presentation of Case: A 75-year-old Japanese lady visited our hospital with fifteen months　duration of non-productive cough and one month exertional dyspnea. Physical examination revealed bilateral fine crackles and squawk at left lung base. Laboratory findings showed elevation of lactate dehydrogenase (LDH) and Krebs von den Lungen-6 (KL-6). Chest high-resolution computed tomography (HRCT) showed mediastinal lymphadenopathy, left lower lung field dominant reticular shadow and traction bronchiectasis. In terms of pulmonary function test (PFT), percent predicted vital capacity (%VC), forced vital capacity (FVC) and percent predicted forced vital capacity (%FVC) were 71.2%, 1.12L and 52.8%, respectively. Based on clinical course, laboratory findings and chest imaging, we considered possibility of fibrotic non-specific interstitial pneumonia (f-NSIP).She undertook video-assisted thoracoscopic surgery (VATS). Specimens were taken from left upper lobe and lower lobe. Pathological findings showed well-formed peri-lymphatic granuloma, architectural destruction with dense fibrosis and microscopic honeycombing. According to the clinical-radiological-pathological discussion, we diagnosed this case as fibrotic sarcoidosis. We commenced oral prednisolone 30 mg/day, treatment response was good including clinical symptoms, laboratory biomarker and chest imaging findings. She is well on prednisolone 2.5 mg/day now. Discussion: This case show similar presentation of f-NSIP both clinically and radiologically. Multidisciplinary discussion was useful for decide to commence adequate management. Conclusion: We present a fibrotic sarcoidosis patient who mimics f-NSIP.
Authors and Affiliations
Tomoo Kishaba, Junya Fukuoka, Yuichiro Nei, Hiroaki Nagano, Shin Yamashiro, Fumihito Kunishima
Keywords
Related Articles
- EP ID EP311798
- DOI 10.9734/BJMMR/2017/33805
- Views 59
- Downloads 0
A Review of Efficacy of Hippotherapy for the Treatment of Musculoskeletal Disorders
Objective: Hippotherapy or Equine Assisted Therapy (EAT) is an alternative therapeutic treatment which is based on the special benefits of horse riding. The purpose of the herein review is to investigate the efficacy of...
Emotional and Social Disorders among Overweight and Obese Children in Enugu, Nigeria: An Evolving Menace
Background: Obesity results mainly from changes in diet and physical activity and currently being regarded as a global epidemic. It comes at a cost, affecting physical, social and psychological health and having deleteri...
Challenges in Providing Rehabilitation Services for People with Disabilities in Iran: A Qualitative Study
Introduction: World Health Organization (WHO) recognizes disability as a global public health issue and a development priority, but unfortunately, the evidence shows that people with disabilities (PWD) often have lower l...
The Recognition of Locomotive Syndrome in 2014: A Cross-Sectional Study in the Orthopeadic Outpatients in Tokyo
Background: To prevent locomotor dysfunction, the Japanese Orthopaedic Association (JOA) proposed the concept of locomotive syndrome (LS) in 2007, and has carried out numerous campaigns to increase the awareness of LS. W...
Genetic Polymorphisms of CYP2C8 in A Healthy Iranian Population
Aim: The aims of this study were to genotype CYP2C8 in an Iranian population and compare their allelic frequencies with other ethnic groups. Study Site and Duration: Biotechnology Department, School of Pharmacy, Zanjan U...