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成人中酷似肺栓塞的斯怀尔-詹姆斯-麦克劳德综合征:一例报告

Swyer-James-Macleod syndrome mimicking pulmonary embolism in adults: a case report.

作者信息

Lema Girma Deshimo, Melaku Ermiyas Endewunet, Tekle Haile Abebe, Aydagnuhm Getachew Bizuneh, Gebeyaw Enguday Demeke

机构信息

Department of Internal Medicine, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.

Division of Radiology, Department of Internal Medicine, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.

出版信息

J Med Case Rep. 2024 Aug 8;18(1):359. doi: 10.1186/s13256-024-04680-3.

Abstract

BACKGROUND

Swyer-James-MacLeod syndrome (SJMS) is a rare lung condition characterized by a unilateral lung hyperlucency and reduction in the pulmonary vasculature, with or without the presence of bronchiectasis. In the 1950s, Swyer, James, and Macleod simultaneously characterized the syndrome for the first time. It is typically diagnosed in childhood. Adult-onset cases are extremely rare, with little literature available on its clinical presentation and diagnostic challenges. Swyer-James-MacLeod syndrome can mimic other lung disorders, resulting in misdiagnosis and improper treatment.

CASE PRESENTATION

A 49- year-old woman from Debre Berhan, Ethiopia, presented to the emergency department of Hakim Gizaw Teaching Hospital with symptoms and radiographic findings mimicking acute pulmonary embolism. On the basis of the clinical presentation and radiographic findings, the patient was first treated as a probable case of pulmonary embolism. Anticoagulant therapy and oxygen support were initiated. Nevertheless, additional testing using a chest computed tomography angiography revealed left lung hyperlucency, decreased vascularity, bronchiectasis, and a negative result for pulmonary embolism. As a result, Swyer-James-MacLeod syndrome was diagnosed.

CONCLUSION

The symptoms of Swyer-James-MacLeod syndrome can be mistaken for pulmonary embolism, which could lead to ineffective treatment and needless expenses. In individuals presenting with symptoms suggestive of pulmonary embolism, this case emphasizes the significance of considering Swyer-James-MacLeod syndrome as a differential diagnosis, especially in the absence of established risk factors for pulmonary embolism.

摘要

背景

斯怀尔-詹姆斯-麦克劳德综合征(SJMS)是一种罕见的肺部疾病,其特征为单侧肺透亮度增加和肺血管减少,可伴有或不伴有支气管扩张。20世纪50年代,斯怀尔、詹姆斯和麦克劳德首次同时对该综合征进行了描述。它通常在儿童期被诊断。成人发病的病例极为罕见,关于其临床表现和诊断挑战的文献很少。斯怀尔-詹姆斯-麦克劳德综合征可模仿其他肺部疾病,导致误诊和不恰当的治疗。

病例介绍

一名来自埃塞俄比亚德布雷伯哈恩的49岁女性因出现类似急性肺栓塞的症状和影像学表现,前往哈吉姆·吉扎教学医院急诊科就诊。根据临床表现和影像学检查结果,该患者最初被当作可能的肺栓塞病例进行治疗。开始了抗凝治疗和氧气支持。然而,进一步的胸部计算机断层扫描血管造影检查显示左肺透亮度增加、血管减少、支气管扩张,且肺栓塞检查结果为阴性。因此,诊断为斯怀尔-詹姆斯-麦克劳德综合征。

结论

斯怀尔-詹姆斯-麦克劳德综合征的症状可能被误诊为肺栓塞,这可能导致治疗无效和不必要的费用。对于出现提示肺栓塞症状的患者,本病例强调了将斯怀尔-詹姆斯-麦克劳德综合征作为鉴别诊断的重要性,尤其是在没有肺栓塞既定危险因素的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecd6/11308721/f3ae5f7617eb/13256_2024_4680_Fig1_HTML.jpg

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