Sinobronchial allergic mycosis syndrome in an elderly male

Autor:	Masaru Tsukui, Masahiro Uehara, Eisuke Mochizuki, Tsutomu Kubota, Miyuki Nagaoka, Naoki Koshimizu, Yasutaka Mochizuka, Shinichiro Mikura, Hyogo Naoi, Kyohei Oishi, Ichirota Nameki, Shun Matsuura
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	0301 basic medicine Nasal cavity lcsh:Immunologic diseases. Allergy Pathology medicine.medical_specialty Lung Bronchiectasis business.industry Pleural effusion Case Report General Medicine respiratory system medicine.disease 03 medical and health sciences 030104 developmental biology 0302 clinical medicine medicine.anatomical_structure Paranasal sinuses 030228 respiratory system medicine Allergic bronchopulmonary aspergillosis business lcsh:RC581-607 Mycosis Respiratory tract
Zdroj:	Allergy, Asthma & Clinical Immunology, Vol 15, Iss 1, Pp 1-6 (2019) Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
ISSN:	1710-1492
DOI:	10.1186/s13223-019-0349-y
Popis:	Background Allergic bronchopulmonary aspergillosis (ABPA) and allergic fungal rhinosinusitis (AFRS) are characterized by hyper-responsiveness of the respiratory tract and the nasal cavity and paranasal sinuses, respectively to Aspergillus species and AFRS causes chronic rhinosinusitis. Herein, we report the first case of sinobronchial allergic mycosis (SAM) syndrome, defined as ABPA with concomitant AFRS, caused by Aspergillus fumigatus patient > 80 years. Case presentation An 82-year-old male with interstitial pneumonia who returned for follow-up exhibited high-attenuation mucus plug in the right intermediate bronchial trunk, infiltration in the right lung field, and right pleural effusion on regular chest computed tomography (CT). We found unilateral central bronchiectasis in the right upper lobe. Similarly, CT scan of the paranasal sinuses revealed high-attenuation mucus plugs in left ethmoid sinuses. Biopsy specimens from the plugs in the right intermediate bronchial trunk and the left ethmoid sinuses revealed allergic mucin with layers of mucus eosinophils, eosinophil-predominant mixed inflammatory cell infiltrate and Aspergillus hyphae. The patient fulfilled all the major criteria for ABPA and AFRS, and was diagnosed with SAM syndrome. CT scan of the lung and paranasal sinuses revealed apparent amelioration after oral steroid therapy. Conclusion Despite mostly reported in relatively young patients, SAM syndrome can occur in elderly individuals as well.
Databáze:	OpenAIRE
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