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产后左肺发育不全合并右侧结核性胸腔积液:一例报告。

Left lung hypoplasia with a right tuberculous pleural effusion after childbirth: A case report.

作者信息

Lin Shan, Guan Wei, LaZhou CuoMao, Shi Yingqing

机构信息

Department of Respiratory Medicine, Qinghai University Affiliated Hospital, Xining, China.

出版信息

Medicine (Baltimore). 2018 May;97(21):e10868. doi: 10.1097/MD.0000000000010868.

Abstract

RATIONALE

Unilateral hypoplasia of the lung is a rare congenital condition, the mechanism of which is poorly understood. Primary pulmonary hypoplasia occurring in an adult is extremely rare and we present what is probably the first case of a link to a tuberculous pleural effusion in a young woman after childbirth.

PATIENT CONCERNS

Herein, we describe a 31-year-old woman with left lung hypoplasia, and she not only survived to adulthood without problems, but was able to deliver a baby in natural labor.

DIAGNOSES

Left lung hypoplasia, right tuberculous pleural effusion.

INTERVENTIONS

We initiated an anti-tuberculosis treatment for this patient with dose adjustments to her weight of isoniazid (0.3 g/day), rifampicin (0.45 g/day), pyrazinamide (1.5 g/day), and ethambutol (0.75 g/day) for 2 months then isoniazid and rifampicin for another 4 months.

OUTCOMES

Ten days later after beginning therapy, she became afebrile and the pleural effusion resolved. No recurrence was observed during a 6-month follow-up period.

LESSONS

In clinical practice, if one sees a chest x-ray revealing complete or incomplete opacification of a hemithorax with volume loss and history of repeated respiratory infections, one should consider the possibility of unilateral pulmonary hypoplasia. In such cases, regular close follow-up is important to minimize infections and to prevent development of cor pulmonale or respiratory failure.

摘要

原理

单侧肺发育不全是一种罕见的先天性疾病,其发病机制尚不清楚。成人原发性肺发育不全极为罕见,我们报道了可能是首例产后年轻女性中与结核性胸腔积液相关的病例。

患者情况

在此,我们描述一名31岁的左肺发育不全女性,她不仅成年后无问题存活下来,还能自然分娩。

诊断

左肺发育不全,右结核性胸腔积液。

干预措施

我们对该患者启动抗结核治疗,根据其体重调整剂量,异烟肼(0.3克/天)、利福平(0.45克/天)、吡嗪酰胺(1.5克/天)和乙胺丁醇(0.75克/天)治疗2个月,然后异烟肼和利福平再治疗4个月。

结果

治疗开始10天后,她退热,胸腔积液消退。在6个月的随访期内未观察到复发。

经验教训

在临床实践中,如果看到胸部X线显示半侧胸腔完全或不完全浑浊伴肺容积缩小且有反复呼吸道感染史,应考虑单侧肺发育不全的可能性。在这种情况下,定期密切随访很重要,以尽量减少感染并预防肺心病或呼吸衰竭的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e2e/6393107/1687b937a8aa/medi-97-e10868-g001.jpg

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