e-ISSN 2147-2475

Hzl Arama




RESPIRATORY CASE REPORTS - Respir Case Rep: 11 (1)
Cilt: 11  Say: 1 - ubat 2022

OLGU SUNUMU
1.
Post COVID-19 Hastalarnda Youn Bakm Sonras Tele Pulmoner Rehabilitasyon: Olgu Serisi
Post Intensive Care Tele Pulmonary Rehabilitation in Post-COVID-19: A Case Series
Mustafa Engin ahin, Seher Satar, Pnar Ergn
doi: 10.5505/respircase.2022.92195  Sayfalar 1 - 8
COVID-19 pnmonisi nedeniyle youn bakm nite-sinde takip edilen olgularda taburculuk sonras Pul-moner Rehabilitasyon (PR) uygulama gerekelerinin banda youn bakmda edinilmi kas gszl, youn bakm sonras sendrom (PICS), psikolojik dis-fonksiyon, vcut kompozisyonu deiiklikleri yer al-maktadr. Pandemi srecinde yz yze PR uygulama-larndaki kstllklar tele-PR yi ne karsa da, PR iin uygun hasta profili hala bilinmiyor. Bu olgu serisinde YB sonras ynlendirilen be olguda video konfe-rans aracl tele-PR yz yze formatla hibrid olarak uygulanmtr. Ayaktan PR nitesinde ilk ve son deer-lendirmeler ile ilk iki egzersiz seans yapldktan sonra video konferans yntemiyle programa devam edildi. Toplam 18 seans sonunda nefes darl algsnda azalma, egzersiz kapasitesinde ve kas kuvvetinde art oldu. COVID-19 ilikili yorgunluk iddetinde azalma saptand.
Muscle weakness acquired in intensive care, post-intensive care syndrome, psychological dysfunction and changes in body composition are the main rea-sons cited in Pulmonary Rehabilitation (PR) applica-tions after discharge in cases followed up in the in-tensive care unit (ICU) due to COVID-19 pneumonia. Although the limitations of face-to-face PR applica-tions during the pandemic have made tele-PR more common, the appropriate patient profile for PR is still unknown. In this case series, video conferencing-mediated tele-PR was applied as a hybrid approach and compared with PR in a face-to-face format in five cases referred after ICU. After the initial and final evaluations and the first two exercise sessions were performed in the outpatient PR unit, the program was continued via a video-conferencing method. At the end of the total 18 sessions, a decrease was noted in the perception of dyspnea, and an increase in exer-cise capacity and muscle strength. A decrease in the severity of COVID-19-related fatigue was also noted.

2.
Ar COVID-19 Pnmonisinde Diabetes nsipitus
Diabetes Insipidus in Severe COVID-19 Pneumonia
zge Peken, Kezban zmen Sner, Halil Kzlk, Havva Kocayiit, Ali Fuat Erdem
doi: 10.5505/respircase.2022.30316  Sayfalar 9 - 12
Coronovirs 2019 (COVID-19), oklu organ yetmezlii ve lmle sonulanabilen bir solunum sistemini enfeksiyonudur. COVID-19 hastalarnda, proteinri, yksek kan re, plazma kreatinin, rik asit ve d-dimer seviye-leri bbrek disfonksiyonu olarak bildirilmitir. Krk dokuz yanda erkek hasta, COVID-19 pnmonisi ve solunum yetmezlii tanlar ile youn bakma kabul edildi. Olgunun youn bakm takibinde, elektrolit dengesizlii ve bbrek yetmezlii gelimeksizin diabetus insipitus (DI) tespit edildi. Hastann santral DI etyolojisi asndan ekilen kontrastl beyin ve hipofiz MR grntlemesi normal olarak deerlendirildi. Hastann ald tedavilerde, poliriye neden olacak ila yoktu. Kan test-lerinde elektolit dengesizlii tespit edilmedi. Hastada nefrojenik DI' a neden olabilecek baka bir bulgu ve hastalk tespit edilmedi. Bu olgu sunumu, COVID-19 enfeksiyonuna bal grlen nefrojenik DI olmas asndan litaratrdeki ilk sunumdur. Ar COVID-19 hastalar ve DI ilikisinin ortaya konulmas iin daha ok almaya ihtiya vardr.
Coronavirus disease 2019 (COVID-19) usual-ly presents as a respiratory infection, and may progress to multiple organ failure and eventually death. In COVID-19 patients, kid-ney dysfunctions reported proteinuria, ele-vated markers of blood urea nitrogen, plasma creatinine, uric acids, and D-dimer. We present here the case of a 49-year-old male who was admitted to the intensive care unit (ICU) with COVID-19 pneumonia and respiratory failure. Diabetes insipidus (DI) developed during intensive care follow-up without electrolyte imbalance or kidney failure. A contrast-enhanced brain and pitu-itary MRI was performed to identify the eti-ology of the central DI, but revealed no pathological findings. The drugs used to treat our patient had no polyuria side ef-fects. No electrolyte imbalance was identi-fied from a blood test of our patient, and there were no findings of other diseases in the differential diagnosis that could lead to nephrogenic DI. We present here a case of COVID-19 infection complicated by nephrogenic diabetes insipidus, given the lack of reports in literature indicating the occurrence of diabetes insipidus alongside COVID-19 infection.

3.
Akcier Kanserini Taklit Eden COVID-19 Enfeksiyonuna Bal Kaviter Pulmoner Lezyon
Cavitary Pulmonary Lesion Due To COVID-19 Infection Mimicking Lung Cancer
Seher Satar, Mustafa Engin Sahin, Pinar Ergun
doi: 10.5505/respircase.2022.35403  Sayfalar 13 - 18
Coronavirus hastal 2019 (COVID-19) srasnda eitli radyolojik bulgular tespit edilebilir. COVID-19 sonras radyolojik olarak akcier kanserini dnd-ren kaln duvarl kaviter lezyonu olan orta yal bir hastay sunuyoruz. Hastamzda kaviter akcier lezyon-larnn etiyolojik faktrlerinden bir ou aratrld ve herhangi spesifik bir neden bulunamad. Ampirik ikili antibiyotik tedavisi sonras kontrol toraks bilgisayarl tomografisinde kaviter ve nodler lezyonlarn tama yakn geriledii gzlendi. Bu nedenle hastamzn kavitesini COVID-19'un ge bir komplikasyonu ola-rak deerlendirdik ve ayrca COVID-19 enfeksiyonu sonras hastalarn klinik verileri ve laboratuvar deer-lerinin yan sra radyolojik bulgular ile de izlenmesi-nin nemini vurguladk.
Various radiological findings have been detected associated with SARS-CoV-2 (COVID-19). We pre-sent here a middle-aged patient with a thick-walled cavitary lesion resembling lung cancer radiologically after COVID-19. Most of the etiological factors for cavitary lung lesions were investigated, and no specif-ic cause was found. After empirical dual antibiotic treatment, the cavitary and the nodular lesion were observed to regress almost completely in control thorax computed tomography. For this reason, we considered the cavity of our patient as a late compli-cation of COVID-19 and also we advocate the im-portance of monitoring patients with clinical data and laboratory values as well as radiological findings after contracting COVID-19.

4.
Hafif COVID-19 Sonras Gecikmi Pulmoner Emboli: Olgu Sunumu
Delayed Pulmonary Embolism after Mild COVID-19: A Case Report
Fatma Tokgz Akyl, Seda Tural Onur, Kbra Gl Klnarslan, Kaan Kara, Mustafa Vedat Doru, Nurdan imek Veske, Melih Akay Arslan
doi: 10.5505/respircase.2022.42744  Sayfalar 19 - 24
Yeni koronavirs hastal (COVID-19) derin ven trombozu (DVT) ve pulmoner emboli (PE) sklnda art ile ilikilendirilen koaglopati ile dikkat ekmitir. Bu olgu sunumunda hafif COVID-19 sonras saptanan bilateral yaygn PE olgusu tartlmtr. Elli yedi yanda, eforla artan nefes darl ikayetiyle polikliniimize bavurdu. Dokuz yl nce PE geirmi, genetik bir risk faktr saptanmamt. Drt buuk ay nce COVID-19 tans konulmu, hafif semptomlar ile dzelmiti. Daha sonra drt kez efor dispnesi nedeniyle polikliniimize bavurmu, dier nedenler dlanm, yksek d-dimer dzeyleri nedeniyle ekilen iki toraks bilgisayarl tomografi anjiyografi (BTA) ve perfzyon sintigrafisinde emboli saptanmamt. Uzun sre devam edilen PE profilaktik tedavisi 33 gn nce kesilmiti. D-dimer dzeyinde art nedeniyle yeniden BTA ekilen hastada bilateral ana pulmoner arterlerde trombs saptand. Sonu olarak, hafif COVID-19 hastal geiren hastalarda dahi, devam eden semptomlar, yksek D-dimer dzeyleri ve daha nceki PE yks; daha uzun sren COVID-19 koaglopatisi iin uyarc olabilir.
COVID-19 coagulopathy has gained attention due to the strikingly high prevalence of deep vein thrombosis (DVT) and pulmonary embolism (PE). We describe here a case of bilateral PE preceded by mild COVID-19 contracted 4.5 months earlier in a male patient who presented to the outpatient clinic with exertional dyspnea. The patient had developed PE 9 years earlier, when no underlying genetic factor was detected. In the 4.5 months after contracting mild COVID-19, he presented four times with exertional dyspnea and a thorax computer tomography angiography (CTA) on two occasions and one perfusion scintigraphy revealed no embolism. Based on his high D-dimer values, his symptoms and his history of PE, he was placed on prolonged PE prophylaxis, which was stopped 33 days ago, and at that time, CTA revealed extensive bilateral PE. In conclusion, an unusually longer activation in COVID-19 coagulopathy may co-exist in patients with a history of previous PE, ongoing symptoms and increased D-dimer levels, irrespective of the COVID-19 severity.

5.
COVID-19 ve Renal Arter Trombozu: Olgu Sunumu
COVID-19 and Renal Artery Thrombosis: A Case Report
Recai Ergn, Dilek Ergn, Hacer Srer Shalabi, Mahmoud Yousef Shalabi, Fikret Kanat, Baykal Tulek, Burcu Yormaz, Alaaddin Nayman
doi: 10.5505/respircase.2022.40374  Sayfalar 25 - 29
COVID-19 pandemisinin balangcndan bu yana, artan kantlar, enfekte hastalarn yksek bir trombotik komplikasyon insidans sergilediini gstermektedir. Covid-19' da solunum semptomlar baskn olsa da, COVID-19' lu hastalarda ekstrapulmoner tutulum da olabilir.
Since the onset of the COVID-19 pandemic, there is increasing evidence that infected patients exhibit a high incidence of thrombotic complications. Although respiratory symptoms are dominant in COVID-19, those with the condition may have extrapulmonary involvement.

6.
diopatik Pulmoner Hipertansiyonlu Bir Hastada Oral Selexipagden Subkutan Treprostinile Gei: Sekiz Gnlk Bir Protokol
Transition from Oral Selexipag to Subcutaneous Treprostinil in a Patient with Idiopathic Pulmonary Arterial Hypertension: An Eight-Day Protocol
Wan-jing Ho, Chia-pin Lin, Lung-An Hsu, Chun-li Wang
doi: 10.5505/respircase.2022.55476  Sayfalar 30 - 35
Pulmoner arteriyel hipertansiyon (PAH) ilerleyici ve gten drc bir hastalktr. Spesifik ilalar, nitrik oksit, endotelin ve prostasiklin yollarn hedeflemektedir. Oral ilalar genellikle dk riskli hastalarda uygulanrken, yksek riskli hastalarda, zellikle WHO fonksiyonel snf IV olanlarda veya oral ilalarn teraptik hedeflerine ulaamayanlarda, parenteral prostanoidler nerilmektedir. Selexipag, selektif bir prostasiklin (PGI2) reseptr agonistidir. Treprostinil bir prostasiklin analoudur. Oral seleksipagdan subkutan (SC) treprostinile gei iin standart bir klavuz yoktur. diyopatik PAH'l bir hastada bu geie baarl bir yaklam tanmladk. Klinik uygulamada faydal bir rehber olabilecek 8 gnlk bir protokol sunuyoruz. Oral seleksipag'n SC treprostinile tahmini edeer dozlar gnde iki kez 200 g = 5 ng/kg/dk'dr. Geiten sonra semptomlarda, serum B tipi natriretik peptit seviyelerinde, oksijen satrasyonunda ve ekokardiyografik parametrelerde iyilemeler oldu.
Pulmonary arterial hypertension (PAH) is a progressive and debilitating disorder. Specific medications target the nitric oxide, endothelin and prostacyclin pathways. Oral medications are usually administered in low-risk patients, while parenteral prostanoids are recommended for those at high risk, especially those with a WHO functional class of IV or those in whom the therapeutic goals of oral medications were not achieved. Selexipag is a selective prostacyclin (PGI2) receptor (IP receptor) agonist, while Treprostinil is a prostacyclin analog. There are no standard guidelines directing the transition from oral selexipag to subcutaneous (SC) treprostinil. We describe here a successful approach to this transition in a patient with idiopathic PAH, proposing an 8-day protocol that may serve as a useful guide in clinical practice. The estimated equivalent doses of oral selexipag to SC treprostinil is 200 g twice daily = 5 ng/kg/min. Following the transition, the patient experienced improvements in symptoms, serum B-type natriuretic peptide levels, oxygen saturation and echocardiographic parameters.

7.
Geleneksel Total Akcier Lavaj Tekniine Yeni Bir Yaklamn Uyguland Bir Pulmoner Alveolar Proteinozis Olgusu
A Case of Pulmonary Alveolar Proteinosis in which a New Approach to the Traditional Whole Lung Lavage Technique is Preformed
Gksel Altnk, Nilfer Yiit, Beste Metin, Merve Trkarslan, lknur Hatice Akbudak
doi: 10.5505/respircase.2022.98470  Sayfalar 36 - 40
Pulmoner alveolar proteinozis, proteinler ve lipitlerden oluan yzey aktif maddenin alveollerde birikmesiyle karakterli nadir grlen bir interstisyel akcier hastaldr. Yarm asr akn sredir kullanlan ve gnmzde de altn standart tedavi kabul edilen Tam Akcier Lavaj (TAL) protokolleri merkezlere gre deimekte standart bir lavaj teknii bulunmamaktadr. Alveoler boluun mekanik ykamasnn esas olduu TAL uygulamalarmzda kullandmz manuel vibrasyon yntemi yerine kullanarak gzlemsel olarak daha iyi sonu aldmz, hastann gs kafesini gl ve ritmik hareketlerle titretiren, teknoloji gerektirmeyen bir yntemi bu olgu sunumunda tanmlamay amaladk. Bu olgu sunumumuzda ayrca, hipoksemi derinlemeden derlenme odasnda uygulanacak CPAP tedavisiyle youn bakm yatnn nleyebileceine dikkat ekmeyi amaladk. Sonuta olgu sunumumuz, TAL tekniine eklenmek zere tariflediimiz kolay eriilebilir ve uygulanabilir olan vibrasyon yntemiyle daha fazla akcier alannn lavaja katldn, postoperatif derlenme srasnda uygulanacak CPAP destei ile TAL sonras hastalarn youn bakma yatlarnn azalabilecei ynndeki gzlemlerimizi iermektedir.
Pulmonary alveolar proteinosis is a rare interstitial lung disease that is characterized by an accumulation of surfactant composed of proteins and lipids in the alveoli. Whole Lung Lavage (WLL) protocols, which have been used for more than half a century and are still considered the optimum approach, vary according to centers, and there is no standard lavage technique. In this case report we describe a method that does not require technology in which the patient's chest is vibrated with strong and rhythmic movements, using it instead of the manual vibration method used in our WLL applications for the mechanical washing of the alveolar space. In this case report, we also draw attention to the fact that intensive care hospitalization can be prevented by CPAP treatment in the recovery room before hypoxemia deepens. In conclusion, our case report shows that more lung areas can be included in the lavage through the addition of the easily accessible and applicable vibration method that we describe to the WLL technique. The study also reports on our observations that CPAP support applied during postoperative recovery can reduce the hospitalization of patients in intensive care after WLL.

8.
lgin Bir Adenokanser Olgusu: Milier Metastaz
An Interesting Case of Adenocarcinoma: Miliary Metastases
Canatan Tademir, Yusuf Aydemir
doi: 10.5505/respircase.2022.01488  Sayfalar 41 - 43
Akcierlerde yaygn milier grnm daha ok tberkloz, sarkoidoz ve pnmokonyozlarda gzlenir. Baz kanserlerin akciere hematojen metastazlar da, nadiren milier grnm yapabilir. Biz milier dalm gsteren ve bronkoskopi ile tan koyduumuz bir primer akcier adenokarsinomu olgusunu sunduk.
Diffuse miliary lesions in the lungs are mostly observed in tuberculosis, sarcoidosis and pneumoconiosis, while hematogenous metastases of some cancers of the lung may rarely have a miliary appearance. We present here a case of primary lung adenocarcinoma with miliary lesions and diagnosed by bronchoscopy.

9.
Aripiprazol Kullanmna Bal Nadir Grlen nterstisyel Pnmoni: Olgu Sunumu
Rare Interstitial Pneumonia Due to the Use of Aripiprazol: A Case Report
Glistan Alpagat, Aye Baccolu, Smeyra Alan Yalm, Merve Poyraz, Betl Dumanou, Aye Fsun Kalpaklolu
doi: 10.5505/respircase.2022.80948  Sayfalar 44 - 49
nterstisyel akcier hastalklarnn (IAH) %2-3'unun ilalara bal olduu ve ilaca bal akcier hastalklarnn %70'inin IAH'dan olduu kabul edilmektedir. Elli bir yanda kadn hasta 3 yldr bipolar bozukluk iin aripiprazol kullanmakta ve 2 yldr astm tedavisi grmekteydi. Hastann klinii, solunum fonksiyon testinde (SFT) restriktif patern olmas, azalm karbon monoksit difzyon testi, laboratuvar sonular, radyolojik bulgular ve biyopsi ile IAH dnld. Olas etiyolojiler: enfeksiyon, aspirasyon, kalp yetmezlii, evcil hayvan besleme durumu, tehlikeli solunum maddelerine maruziyet dland. pheli ila kesilerek, oral kortikosteroid tedavisi baland. la tedavileri ile akcier toksisitesi geliebilir. la yks ayrntl olarak sorgulanmal ve phe durumunda derhal kesilmelidir. IAH nadir grlr; ilatan phelenilmez de devam edilirse hastalk kronikleebilir ve solunum yetmezliine ilerleyebilir. Hastalkla ilgili farkndal artrmak iin bu olguyu sunmaya amaladk.
It is accepted that 23% of interstitial lung diseases (ILD) are due to drugs, and that 70% of drug-induced lung diseases are due to ILD. We present here the case of a 51-year-old female patient who had been taking aripiprazole for bipolar disorder for 3 years and had been undergoing asthma treatment for 2 years. ILD was considered based on the patient's clinic, a restrictive pattern in the pulmonary function test (PFT), a decreased carbon monoxide diffusion test, laboratory results, radiological findings and biopsy. The possible etiologies of infection, aspiration, heart failure, pet feeding status and exposure to hazardous respiratory substances were excluded. The suspected drug was discontinued and oral corticosteroid treatment was started. Lung toxicity can develop with drug treatments, and so drug history should be questioned in detail and discontinued immediately in case of any doubt. ILD is rare, and if the drug is not suspected and continued, the disease may become chronic and progress to respiratory failure. We present this case to increase awareness of the disease.

10.
Yetikinlikte Tan Alan Williams-Campbell Sendromu: Nadir Bir Bronektazi
Williams-Campbell Syndrome Diagnosed in Adulthood: A Rare Entity of Bronchiectasis
Kbra Gl Klnarslan, Fatma Tokgz Akyl, Neslihan Boyrac, Metin Sucu, Melih Akay Arslan, Hlya Abal, Kaan Kara, Seda Tural nr
doi: 10.5505/respircase.2022.94546  Sayfalar 50 - 54
Williams-Campbell sendromu, bron duvar kartilaj oluum eksikliinden veya tamamen yokluundan kaynaklanan, distal hava yolu kollaps ve bronektaziye neden olan nadir bir sendromdur. Sendrom ilk olarak infant dnemde tanmlanm olup ocukluk dneminden itibaren, ksrk wheezing gibi obstrktif semptomlar ve tekrarlayan pnmoniler ile seyreder. Erikin yata olgular ok nadir bildirilmitir. Krk yanda erkek hasta, bir haftadr giderek artan nefes darl, ksrk, ate ikayetleriyle bavurdu. On yldr bronektazi tans olan hastann ylda birka kez enfeksiyon geirme yks mevcuttu. Enfeksiyon parametrelerinde ykseklik saptanan hasta enfekte bronektazi tans ile yatrld. nspiryumda ve ekspiryumda ekilen tomografilerde youn hava hapsi, ekspiryumda hava yolu kollaps izlenen hastann kistik broniektazi etyolojisi aratrld. Galaktomannan antijeni negatifti, immnglobulin dzeyleri ve alfa 1-antitripsin deerleri normal snrlarda saptand. Hastaya klinik ve radyolojik bulgular eliinde Williams-Campbell sendromu tans konuldu. Antibiyoterapi sonras klinik yant alnan hasta pulmoner rehabilitasyon programna alnarak akcier nakli asndan deerlendirilmek zere ynlendirildi. Sonu olarak, Williams-Campbell sendromu erikin yata da tan konulabilen nadir bir sendromdur ve tm yalarda bronektazi etyolojisinin aratrlmas hasta ynetimine katk salayacaktr.
Williams-Campbell syndrome is a rare condition caused by a deficiency or complete absence of bronchial wall cartilage formation, resulting in distal airway collapse and bronchiectasis. The syndrome, generally encountered first during infancy, progresses with recurrent pneumonia with such obstructive symptoms as cough and wheezing from childhood onwards, while adult cases are rarely reported. A 40-year-old male patient presented with complaints of shortness of breath, cough and fever for one week. He was hospitalized with a diagnosis of bronchiectasis exacerbation due to elevated infection parameters, when radiology revealed extensive cystic bronchiectasis, air trapping and airway collapse at expiration. After excluding other etiologies, the patient was diagnosed with Williams-Campbell syndrome in light of the clinical and radiologic findings. He was discharged following clinical response and started on a pulmonary rehabilitation program, was referred to a lung transplantation clinic. The case is representative of the set of rare adult cases showing that Williams-Campbell syndrome can be diagnosed in adulthood, and signaling that the etiology of bronchiectasis should be further evaluated in advanced ages.

LookUs & Online Makale