Prognostic value of coexisting conditions and complications in pleuroparenchymal fibroelastosis: a single-center retrospective study.

BACKGROUND: Pleuroparenchymal fibroelastosis (PPFE) is a rare idiopathic interstitial lung disease (ILD) characterized by subpleural parenchymal fibrosis and elastosis mainly in the upper lobes. PPFE occurs in a secondary form that overlaps with underlying medical conditions or complications. This study evaluated the clinical impact of coexisting factors on the survival of patients with PPFE. METHODS: Fifty-five PPFE patients were retrospectively evaluated. The patients' diagnoses were categorized as "idiopathic PPFE" with no known cause or "secondary PPFE" with underlying medical conditions or complications. The clinical characteristics and survival rates of these groups were compared. RESULTS: Twenty-eight patients (50.9%) were diagnosed with idiopathic PPFE and 27 (49.1%) with secondary PPFE, including cases of occupational dust exposure, connective tissue disease (CTD), post-hematopoietic stem cell transplantation (HSCT), and a family history of ILD. The idiopathic and secondary PPFE groups had similar clinical features, laboratory tests, and pulmonary function profiles, including a low body mass index, normal Krebs von den Lungen-6, high surfactant protein-D, and high residual volume/total lung capacity. In the secondary PPFE group, post-HSCT was associated with a worse prognosis, and CTD was associated with better prognosis. A multivariate analysis demonstrated that post-HSCT and a reduced forced vital capacity were significantly associated with a worsened survival in patients with PPFE. CONCLUSIONS: The prognosis of PPFE is highly influenced by underlying medical conditions or complications. Patients with post-HSCT PPFE should be monitored particularly closely, as they are at higher risk of a poor prognosis than others.

Ultrasound-assisted insertion of a small-diameter thoracic catheter for acute dorsal empyema.

Key Clinical Message: Ultrasound-assisted small catheter placement may be considered in cases where computed tomography guidance is unavailable, and ultrasound can identify pleural effusions clearly, even in cases where empyema is localized solely on the dorsal side. Abstract: Thoracic catheter insertion for empyema can be challenging when the pleural effusion is localized dorsally and computed tomography guidance is unavailable. We report the case of a 40-year-old man with acute dorsal bacterial empyema who underwent successful ultrasound-assisted catheter placement in an orthopneic position.

Streptococcal Toxic Shock Syndrome Caused by Streptococcus dysgalactiae subsp. equisimilis-related Empyema: A Novel Case Report.

Streptococcal toxic shock syndrome (STSS) caused by Streptococcus dysgalactiae subsp. equisimilis (SDSE)-related empyema is rare but can result in shock vitals, acute kidney injury, and extensive erythema. In the present case, a 92-year-old woman with empyema caused by SDSE developed STSS after pleural drainage and antibiotic therapy. Despite temporary improvement with clindamycin and pleural drainage, the patient ultimately died due to malnutrition. Autopsy findings suggested that the infection was well controlled, but infections with Streptococcus spp., including SDSE, can trigger STSS in patients with empyema.

Home high-flow nasal therapy in a patient with pleuroparenchymal fibroelastosis: A case report.

A 62-year-old man with pleuroparenchymal fibroelastosis (PPFE), who had been under observation for 19 years, was admitted due to headache, fatigue, and dyspnea. Although no acute findings were detected, his symptoms were attributed to hypercapnia and exertional hypoxemia. He had a history of pneumothorax, but chose not to undergo positive airway pressure ventilation. Consequently, home high-flow nasal therapy (HFNT) was initiated, and 4 months later, he observed an improvement in his quality of life, body weight gain, and relief from hypercapnia. These outcomes suggested that home HFNT holds potential for improving the quality of life for patients with PPFE.

Medication-related osteonecrosis of the jaw leading to sepsis in a patient with rheumatoid arthritis: A case report and clinical implications.

Key Clinical Message: Chronic use of bisphosphonates, in combination with immunosuppressive therapy, increases the risk of jaw osteonecrosis. When sepsis occurs in patients receiving bisphosphonate, osteonecrosis of the jaw should be considered a potential source of infection. Abstract: Reports of medication-related osteonecrosis of the jaw (MRONJ) accompanied by sepsis are limited. A 75-year-old female patient with rheumatoid arthritis, receiving treatment with bisphosphonate and abatacept, developed sepsis secondary to MRONJ. When sepsis occurs in patients receiving bisphosphonate, osteonecrosis of the jaw should be considered a potential source of infection.

Primary pleural lymphoma accompanied by silicosis.

Reports of malignant lymphoma accompanied by silicosis are limited. A 93-year-old man with silicosis presented with right massive pleural effusions and was diagnosed with primary pleural lymphoma. Since there was no evidence of chronic pyothorax or Epstein-Barr virus infection, it may be due to silicosis-associated chronic inflammation.

Large lung mass lesion with spontaneous regression in a patient with IgG4-related lung disease.

IgG4-related lung disease (IgG4-RLD) may present with a variety of radiological findings, but large lung mass lesion are rare. Although steroid therapy is strongly recommended for IgG4-RLD with or without symptoms, respirologists should be aware that some patients may not need steroid therapy.

Utility of beta-human chorionic gonadotropin in pleural effusions: Report of an autopsy case of a male patient with primary pulmonary choriocarcinoma.

A 69-year-old male patient presented with bloody pleural fluid effusion and elevated beta-human chorionic gonadotropin (ß-hCG) levels obtained by thoracentesis. The patient's condition rapidly deteriorated, and he died. The autopsy revealed primary pulmonary choriocarcinoma. Early diagnosis of choriocarcinoma based on ß-hCG levels in the pleural fluid may be possible.