Swyer-James-Macleod Syndrome In A Geriatric Patient: A Case Report

Abstract

Introduction: Hyper-lucent lung syndrome or Swyer-James-Macleod syndrome is a rare, often an incidental finding, primarily showing unilateral hyper-lucency as a consequence of bronchiolitis obliterans. Often diagnosed in early childhood; though in some cases it may only be discovered in adulthood or on account of recurrent chest infections. Case Presentation: A patient presented to our outpatient center with complaints of shortness of breath with mild to moderate exertional dyspnea & exacerbations of symptoms classically associated with chronic obstructive pulmonary disease. Complaints have persisted for several years with waxing & waning intensity. There is a history of migraine, atrial fibrillation, hypothyroidism, and colon & breast cancer without recurrence. Computed tomography of the chest with intravenous contrast showed asymmetric emphysematous changes with marked hyperinflation & attenuated vasculatures confined to the middle lobe of the right lung. The patient was started on a combination of inhaled long-acting beta-agonists, corticosteroids & long-acting muscarinic antagonists and is almost asymptomatic. Conclusion: Geriatric patients are at increased risk of various age-related diseases, respiratory disorders being among them. Knowledge of this rare condition allows for its appropriate management as it often coexists with bronchiectasis & results in frequent respiratory infections, which may be preventable.