Astımlı bir hastada tesadüfen saptanan Swyer-James sendromu
Swyer-James sendromu (Macleod’s), tek taraflı amfizem olarak bilinmektedir. Bir akciğerin tamamını ya da bir lobunu tutan, nadiren bilateral olan ve beraberinde pulmoner damar sayısında ve çapında azalmanın eşlik ettiği bir tablodur. Bu yazıda, nadir görülmesi nedeniyle astım ve Swyer-James sendromuna sahip bir olgu sunulmuştur. Üç yıl önce astım tanısı konan ve önerilen inhaler ilaçlarını düzensiz olarak kullanan 35 yaşındaki kadın hasta, semptomlarının düzelmemesi nedeniyle polikliniğimize başvurdu. Hastanın yapılan fizik muayenesinde, ekspiryumda düşük frekanslı ronküsleri ve sağ skapula altında solunum seslerinde azalma mevcuttu. Solunum fonksiyon testinde orta derecede obstrüksiyon vardı ve bronkodilatasyon testi pozitifti. Deri testi negatif, total IgE düzeyi normaldi. Yüksek rezolüsyonlu BT’de sağ orta-alt lobda hava hapsi ve vaskülaritede azalma mevcuttu. Ventilasyon/Perfüzyon sintigrafisinde aynı bölgede ventilasyon ve perfüzyonda azalma vardı. Hastanın ekokardiografik ve bronkoskopik incelemeleri normaldi. Bu yazıda, tesadüfen birlikte bulunan ve nadir görülen astım ile Swyer-James Sendromlu bir olgu sunulmuştur.
Swyer-James syndrom: Coincidentally determined in a patients with asthma
Swyer James syndrome (Mc Leod’s syndrome), is known as unilateral emphysema, with involvement of one lobe or whole lung. In addition, decrease in diameter and number of pulmonary arteries are also known. In this report, apatient is presented with Swyer-James syndrome, which is a rare condition, accompanying to asthma. A 35-years aged woman admitted to our hospital with the unresolving symptoms of asthma. Asthma was diagnosed three years ago prior to admission and she has used her medication irregularly since then. Physical examination revealed that low pitched expriatory ronchi and diminished auscultation findings at the right infrascapular region. Moderate airflow limitation was observed in pulmonary function test and bronchodilatation test was found positive. Prick tests for atopy were negative, and serum total Ig-E level was normal. High resolution CT revealed that air-trapping right middle and lower lobes and decrease in vascularity. A decrease in both ventilation and perfusion at the same area in the ventilation/Perfusion scintigraphy. Echocardiographic and bronchoscopic evaluation were all normal. In this paper, a rare combined case of asthma and Swyer-James syndrome, found incidentally, is reported.
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