ABSTRACT
Pulmonary alveolar proteinosis (PAP) is a rare disease of abnormal surfactant production and accumulation. It is typically divided into three main categories: autoimmune, secondary and genetic. The genetic type is more common in children and adolescents, while the autoimmune type is most commonly seen in adults. Here we present an unusual case of autoimmune PAP presenting in an adolescent by mimicking findings of Mycoplasma pneumonia. Although both PAP and Mycoplasma pneumonia may reveal the same findings of the "crazy paving pattern" on computed tomography imaging, it is imperative to distinguish the two as treatment options are dissimilar.
ABSTRACT
Chylothorax is an unusual cause of pleural effusion, typically caused by trauma or malignancy. Waldenstrom's macroglobulinaemia (WM) is a clinicopathological entity demonstrating lymphoplasmacytic lymphoma in the bone marrow with an IgM monoclonal gammopathy in the blood. Recurrent chylous effusions are often resistant to conservative treatment and may require surgical intervention. We present a unique case of a 50-year-old woman with recurrent chylothorax secondary to WM that completely resolved with ibrutinib therapy. To our knowledge, this is the eighth such case reported in literature and the first case of successful resolution of chylothorax with monoclonal antibody therapy.
Subject(s)
Chylothorax/etiology , Pleural Effusion, Malignant/drug therapy , Waldenstrom Macroglobulinemia/complications , Adenine/analogs & derivatives , Chylothorax/drug therapy , Female , Humans , Middle Aged , Piperidines , Pleural Effusion, Malignant/etiology , Pyrazoles/therapeutic use , Pyrimidines/therapeutic use , RecurrenceABSTRACT
Endocardial cushion defects are congenital abnormalities that result in valvular dysfunction as well as defects (or "holes") in the septa of the heart. They are typically diagnosed in early infancy; presentation late in life is rare. We present the case of a 72-year-old female admitted to the hospital with dyspnoea and palpitations. She was found to have multifocal atrial tachycardia. She suffered cardiac arrest associated with refractory hypoxaemia that required mechanical ventilation and vasodilator therapy with inhaled nitric oxide. Echocardiography revealed a large ostium primum atrial septal defect (ASD) complicated by Eisenmenger syndrome. It is likely that her arrhythmia, a sequela from her long-standing congenital abnormality, led to sudden decompensation. In this case presentation, we review the aetiology, presentation, and complications of ASDs.
