Saha Biplab Kumar, Beegle Scott
Pulmonary and Critical Care Medicine, Albany Medical Center Hospital, Albany, New York, USA
Pulmonary and Critical Care Medicine, Albany Medical Center Hospital, Albany, New York, USA.
BMJ Case Rep. 2019 Dec 8;12(12):e232759. doi: 10.1136/bcr-2019-232759.
This case demonstrates chronic fibrosing pleuritis, as a rare pulmonary aetiology for mortality in patients with Degos disease or malignant atrophic papulosis (MAP). Knowledge of this unusual complication will help physicians identify this entity early and provide appropriate treatment.Patients with MAP die from gastrointestinal and brain involvement within 2-3 years of diagnosis. This case is unique as the patient survived for 9 years and died secondary to respiratory failure, which had not been reported before. Our patient was a young man, diagnosed with MAP at the age of 17. His skin and gastrointestinal disease were controlled with eculizumab and parenteral treprostinil. The patient developed severe restrictive pulmonary disease, required ventilatory support, and died from respiratory failure. An autopsy revealed chronic fibrosis pleuritis. Longer surviving patients with MAP might suffer from significant respiratory disease. Pulmonary function test should be obtained to identify subclinical respiratory limitation.
本病例显示了慢性纤维化胸膜炎,这是德戈斯病或恶性萎缩性丘疹病(MAP)患者罕见的肺部死亡病因。了解这种不寻常的并发症将有助于医生早期识别该病症并提供适当治疗。MAP患者在诊断后2至3年内死于胃肠道和脑部受累。该病例独特之处在于患者存活了9年,死于呼吸衰竭,此前未见报道。我们的患者是一名年轻男性,17岁时被诊断为MAP。他的皮肤和胃肠道疾病通过依库珠单抗和肠外曲前列尼尔得到控制。患者出现严重的限制性肺病,需要通气支持,最终死于呼吸衰竭。尸检显示慢性纤维化胸膜炎。存活时间较长的MAP患者可能患有严重的呼吸系统疾病。应进行肺功能测试以识别亚临床呼吸受限。