Excipient lung disease (ELD) is a rare cause of pulmonary hypertension that occurs due to the intravenous injection of crushed tablets. We present the case of a healthcare professional in her late 30s who presented with a fever in the setting of a bacteraemia. During her hospital admission, she established a pattern of transient hypoxia and hypotension, with resolution without targeted management or clear cause identified. She developed progressive pulmonary centrilobular micronodularity on computed tomography and severe pre-capillary pulmonary hypertension. Lung biopsy revealed pulmonary arteriolar deposition of microcrystalline cellulose with an associated giant cell reaction leading to the diagnosis of ELD secondary to injection of crushed oxycodone tablets. In the setting of abstinence from intravenous drug use, the patient made a full recovery. ELD is rare and requires a high index of suspicion to diagnose. Treatment is largely supportive and should include removal of excipient exposure and addiction medicine services.
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http://dx.doi.org/10.1136/bcr-2024-260988 | DOI Listing |
Am J Respir Crit Care Med
January 2025
University of Utah, Division of Cardiovascular Medicine, Department of Medicine, Salt Lake City, Utah, United States.
Rationale: Guidelines recommend patients with pulmonary arterial hypertension (PAH) be referred to pulmonary hypertension (PH) centers, but little is known about where care is actually delivered in the United States (US).
Objectives: To use prescription patterns to estimate the proportion of PAH care delivered at US PH centers and explore factors associated with location of care.
Methods: This retrospective study analyzed claims from the Komodo database in adults who received ≥1 PAH prescription between March 2021 and February 2022.
Cureus
December 2024
Internal Medicine, University of Health Sciences, Lahore, PAK.
Acute coronary syndrome (ACS) remains a major global health burden, encompassing a spectrum of conditions from unstable angina to acute myocardial infarction. Despite advancements in early detection and management, ACS is often complicated by the development of heart failure. This systematic review and meta-analysis aimed to identify factors associated with the development of heart failure following acute coronary syndrome.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Division of Cardiology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa Ward, Tokyo 142-8555, Japan.
Background: Although the prognosis in systemic lupus erythematosus (SLE) has dramatically improved, pulmonary artery hypertension (PAH) is one of the life-threatening comorbidities associated with SLE. The management of the comorbidity is occasionally challenging due to the lack of consensus regarding treatment options including immunosuppressive agents, selective pulmonary vasodilators, and cardiac rehabilitation.
Case Summary: A 28-year-old female who terminated prednisolone after remission of SLE by her own discretion 3 years ago developed dyspnoea on effort.
J Med Case Rep
January 2025
Faculty of Medicine, Damascus University, Damascus, Syria.
Background: Heterotaxia is characterized by an abnormal positioning of the thoracic and/or abdominal organs, resulting in various physiological and hemodynamic implications. Congenital heart disease involves structural irregularities in the heart or major vessels within the chest, leading to functional challenges.
Case Presentation: We present a 26-year-old Arab female patient with a complex medical history involving heterotaxy, dextrocardia, congenital heart disease, and ureteropelvic junction obstruction diagnosed in her first year of life, followed by the identification of endometriosis in her early twenties.
Respir Res
January 2025
Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Background: Pulmonary arterial hypertension (PAH) is a progressive disorder that can lead to right ventricular failure and severe consequences. Despite extensive efforts, limited progress has been made in preventing the progression of PAH. Mitochondrial dysfunction is implicated in the development of PAH, but the key mitochondrial functional alterations in the pathogenesis have yet to be elucidated.
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