Upper Lobe Fibrocavitary Disease in a Patient With Back Pain and Stiffness

Thai, Divya; Ratani, Rita S.; Salama, Sherine; Steiner, Robert M.

doi:10.1378/chest.118.6.1814

Cited by 14 publications

(5 citation statements)

References 12 publications

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“…Apical fibrobullous areas are often targets of aspergillus infection 11 . Chronic aspergillus colonization is identified in 50% to 65% of patients with ankylosing spondyloarthritis 12 .…”

Section: Discussionmentioning

confidence: 99%

Progressive Pulmonary Fibrocystic Changes of Both Upper Lungs in a Patient with Ankylosing Spondylitis

et al. 2015

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Ankylosing spondylitis is a chronic inflammatory multisystem disease that primarily affects the axial joints. Pleuropulmonary involvement is an uncommon extra-articular manifestation of ankylosing spondylitis. There is a wide spectrum of pulmonary parenchymal changes in ankylosing spondylitis, beginning in the early stages of the disease and increasing over time. The lesions are usually asymptomatic, and not visible on chest radiographs in early stages. We reported a case of advanced ankylosing spondylitis in a 56-year-old man with progressive pulmonary bullous fibrocystic changes on both upper lobes that were misdiagnosed as tuberculosis in the early stages of the disease.

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“…Apical fibrobullous areas are often targets of aspergillus infection 11 . Chronic aspergillus colonization is identified in 50% to 65% of patients with ankylosing spondyloarthritis 12 .…”

Section: Discussionmentioning

confidence: 99%

Progressive Pulmonary Fibrocystic Changes of Both Upper Lungs in a Patient with Ankylosing Spondylitis

et al. 2015

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“…These include diminished upper lobe ventilation due to chest wall rigidity, altered apical mechanical stress due to rigid thoracic spine, 3 recurrent pulmonary infection due to impaired cough, and respiratory mechanics as a result of thoracic rigidity. Other theories include prior thoracic irradiation, repeated aspiration pneumonitis secondary to esophageal muscle dysfunction, 10 and cricoarytenoid joint disease 8 …”

Section: Discussionmentioning

confidence: 99%

“…Patients with fibrocystic disease may develop mycetomas and other infections, such as atypical mycobacterium. HRCT is frequently helpful inevaluating the lung apices for the presence of infection, especially mycetoma 8 …”

Section: Discussionmentioning

confidence: 99%

High‐resolution CT pulmonary findings in idiopathic ankylosing spondylitis: correlations with clinical assessment, plain chest X‐ray and pulmonary function tests

Zaki

El-Hadidi

Sami

et al. 2007

APLAR Journal of Rheumatology

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Aim:The aim of this study is to evaluate pulmonary manifestations of ankylosing spondylitis on high-resolution computed tomography (CT) scan and to correlate these findings with clinical assessment, plain chest X-ray and pulmonary function tests. Methods:The study comprised 32 patients (26 males [81.3%], 6 females [18.8%]) who met the modified New York criteria for diagnosis of idiopathic ankylosing spondylitis; in addition 10 normal subjects not complaining of any respiratory symptoms and matched for age and sex served as a control group. All patients were subjected to full history-taking, full clinical examination, chest X-ray, high-resolution computed tomography (HRCT) chest and pulmonary function tests. Results:The abnormalities on HRCT included evidence of apical lung fibrosis in two patients (6.3%), interstitial lung disease in six (18.8%), minor interstitial abnormalities in eight (25%), bronchiectasis in four (12.5%), lung nodules in three (6.3%) and pleural thickening in five patients (6.3%). Nine patients (28.1%) showed negative findings by chest X-ray which revealed positive findings on HRCT. Five patients (15.6%) showed positive findings on both HRCT and plain chest X-ray, and 18 patients (56.3%) showed no findings on both HRCT and chest X-ray. Four patients (12.5%) showed normal pulmonary function tests, 25 (78.13%) showed restrictive pattern, 17 (53.13%) had obstructive pattern and 26 patients (81.3%) had diffusion defects. Conclsuion:The identification of non-apical minor basal interstitial lung disease in our study which was previously reported in other studies, raises a possible association to ankylosing spondylitis. High-resolution CT scan is more sensitive than chest X-rays in detection of such minor interstitial lung disease (ILD), and other parenchymal lung changes.

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“…The reported prevalence of pulmonary disease ranges 0-30% [4,5]. Radiographic manifestations are variable and dependent on the chronicity of the disease [6][7][8][9]. ROSENOW et al [4] reviewed the radiographic findings in 2,080 patients with ankylosing spondylitis; 26 (1.3%) of the patients exhibited apical fibrosis or fibrocavitary disease.…”

Section: Discussionmentioning

confidence: 99%

A patient with ankylosing spondylitis and recurrent haemoptysis

Franquet¹,

Müller²,

Flint³

2004

Eur Respir J

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A 54-yr-old male presented with a history of recurrent episodes of haemoptysis over the previous 2 yrs. The patient also complained of back pain and stiffness for 15 yrs due to ankylosing spondylitis. Over the previous 2 weeks, he had been complaining of progressively increasing dyspnoea, malaise and fever. The fever persisted despite antibiotics and the patient showed acute severe haemoptysis. He drank little alcohol and had ceased smoking a few cigarettes daily 20 yrs previously. He had no previous history of pulmonary tuberculosis.On admission, he was pale and complained of nonproductive cough. His temperature was 37.6uC, pulse rate 98 beats?min -1 , respiratory frequency 30 breaths?min -1 and blood pressure 160/90 mmHg. On physical examination, the patient was a thin male, who appeared comfortable at rest, without respiratory stridor. No lymphadenopathy was evident. The head and neck were normal.

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Upper Lobe Fibrocavitary Disease in a Patient With Back Pain and Stiffness

Cited by 14 publications

References 12 publications

Progressive Pulmonary Fibrocystic Changes of Both Upper Lungs in a Patient with Ankylosing Spondylitis

Progressive Pulmonary Fibrocystic Changes of Both Upper Lungs in a Patient with Ankylosing Spondylitis

High‐resolution CT pulmonary findings in idiopathic ankylosing spondylitis: correlations with clinical assessment, plain chest X‐ray and pulmonary function tests

A patient with ankylosing spondylitis and recurrent haemoptysis

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