SIK TEKRARLAYAN AKCİĞER ENFEKSİYONU NEDENİ OLARAK MOUNİER-KUHN SENDROMU: OLGU SUNUMU
Trakeobronkomegali, trakea ve büyük bronşların anormal genişlemesi ile karakterize bir sendromdur. Trakea ve ana bronşlarda elastik ve müsküler dokudaki atrofi veya eksiklik sonucu oluştuğu düşünülmektedir. Solunum fonksiyonlarının iyi korunduğu minimal hastalıktan bronşektazi, tekrarlayan solunum yolu enfeksiyonları ve solunum yetmezliğine kadar değişen farklı klinik prezentasyonlar gösterilmiştir. Daha önce astım nedeniyle takipli 61 yaşında erkek hasta bir haftadır olan öksürük, ateş ve hırıltı şikâyetleri ile başvurdu. Son 1 yılda 3 kez pnömoni nedeniyle hastaneye yatırılarak tedavi öyküsü olan olgunun toraks bilgisayarlı tomografisinde trakea çapında genişleme ve her iki akciğerde bronşektazi saptandı. Tekrarlayan akciğer enfeksiyonunun eşlik ettiği, trakeobronkomegali olarak kabul edilen bu nadir olgu sunuldu ve ilgili literatür gözden geçirildi.
MOUNIER-KUHN SYNDROME AS A CAUSE OF RECURRENT PULMONARY INFECTIONS: A CASE REPORT
Tracheobronchomegaly is a syndrome characterized by abnormal dilatation of the trachea and main bronchi. This syndrome is thought to be caused by atrophy or absence of elastic fibers and smooth muscle cells in trachea and main bronchi. A broad spectrum of clinical presentations has been documented ranging from minimal disease with good preservation of pulmonary function to bronchiectasis, recurrent respiratory tract infection and respiratory failure. We present the case of a 61-year-old male patient who was admitted to hospital because of cough, fever and wheezing for one week. The patient had a history of hospitalization due to pneumonia 3 times in the last one year. Computed tomography scan showed tracheomegaly and bilateral bronchiectasis. This rare case, considered as tracheobronchomegaly accompanying recurrent pulmonary infection, is presented and the pertinent literature is reviewed.
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- 1. Adani GL, Baccarani J, Lorenzin D, et al. Renal
transplantation in a patient affected by
Mounier-Kuhn syndrome. Transplant Proc
2005; 37: 4215–7.
- 2. Is It Really Difficult-to-treat Asthma? Don't
Forget Other Causes of Wheeze. Ilkay Koca Kalkan,
A. Fusun Kalpaklioglu. World Allergy Organ
J. 2012 February; 5 (Suppl 2): S196. Published
online 2012 February 17.
- 3. Lakshminarayana PH, Woodske ME. MounierKuhn
syndrome: imaging in recurrent
pulmonary infections. Am J Respir Crit Care
Med 2012 Jan 15;185(2):225.
- 4. Dunne MG, Reiner B. CT features of
tracheobronchomegaly. J Comput Assist
Tomogr 1988; 12: 388-91.
- 5. Dee PM. Chest case of the day.
Tracheobronchomegaly- the Mounier Kuhn
syndrome. AJR 1996; 167: 235-8.
- 6. Menon B, Aggarwal B, Iqbal A. Mounier-Kuhn
syndrome: report of 8 cases of
tracheobronchomegaly with associated
complications. South Med J. 2008; 101: 83-7.
- 7. Schwartz M, Rossoff L. Tracheobronchomegaly.
Chest 1994; 106: 1589-90.
- 8. Celik B, Bilgin S, Yuksel C. Mounier-Kuhn
syndrome: a rare cause of bronchial dilation.
Tex Heart Inst J. 2011; 38(2):194-6.
- 9. Fortuna FP, Irion K, Wink C, Boemo JL. Mounier
Kuhn syndrome. J Bras Pneumol 2006; 32:
180–3.
- 10. Marom EM, Goodman PC, McAdams HP. Diffuse
abnormalities of the trachea and main bronchi.
AJR Am J Roentgenol 2001; 176: 713-7.
- 11. Sane AC, Effmann EL, Brown SD.
Tracheobronchiomegaly. The Mounier-Kuhn
syndrome in a patient with the Kenny- Caffey
syndrome. Chest 1992; 102: 618 -9.
- 12. Odell DD, Shah A, Gangadharan SP, Majid A,
Michaud G, Herth F, Ernst A. Airway stenting
and tracheobronchoplasty improve respiratory
symptoms in Mounier-Kuhn syndrome. Chest.
2011; 140: 867-73.