RT Journal Article
SR Electronic
T1 Severe Excessive Dynamic Airway Collapse in a Patient With Primary Sjögren's Syndrome
JF Respiratory Care
FD American Association for Respiratory Care
SP e156
OP e159
DO 10.4187/respcare.02929
VO 59
IS 10
A1 Sophie Ismael
A1 Delphine Wermert
A1 Kim-Diep Dang-Tran
A1 Marion Venot
A1 Jean-Yves Fagon
A1 Jean-Luc Diehl
YR 2014
UL http://rc.rcjournal.com/content/59/10/e156.abstract
AB Airway and cystic lung diseases can be observed in patients with Sjögren's syndrome. We report a case of such a patient suffering from respiratory failure due to recurrent episodes of right pneumothorax, requiring invasive mechanical ventilation. Despite thoracic drainage and adequate pneumothorax management, the patient could not be weaned from the ventilator. Fiberoptic bronchoscopy revealed severe central excessive dynamic airway collapse of the lower part of the trachea and proximal bronchi. The severity of airway collapse was maximal at the intermediate bronchus level, with a near-complete obstruction during expiration. Inspiratory and expiratory computed tomography studies confirmed the fiberoptic findings and suggested a possible expiratory posterior compression of the intermediate bronchus by parenchymal lung cysts. Stenting was considered, but the patient died from ventilator-associated pneumonia before the procedure could be performed. This case is the first description of severe central excessive dynamic airway collapse in a patient with primary Sjögren's syndrome complicated by diffuse airway and cystic lung disease.