NIHON SARUKOIDOSHISU / NIKUGESHUSHIKKAN (The Japanese journal of sarcoidosis and other granulomatous disorders )
Online ISSN : 1884-6122
Print ISSN : 1345-0565
ISSN-L : 1345-0565
A Case of Pulmonary Sarcoidosis with Acute Respiratory Failure
Kiminobu TanizawaTetsuro InoueKazukiyo OidaEisaku TanakaTerufumi KatoMinoru SakuramotoYuji MaedaKunihiko TeradaToshiaki OhnishiSatoshi NomaGen HonjohYoshiaki YubaYoichiro KobashiYoshio Taguchi
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2003 Volume 23 Issue 1 Pages 57-62

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Abstract
A 27-year old male had blurred vision caused by bilateral urevitis 1 month before admission. He had left supraclavicular and bilateral hillar lymphadenopathy 10 days before. Biopsy of suparaclavicular lymph node was performed five days before, which revealed sarcoid nodules. From the night before his admission he had productive cough and progressive dyspnea and was admitted urgently due to acute respiratory failure with PaO2 54.5mmHg. His chest x-ray showed diffuse consolidations with bilateral hillar lymphadenopathy. His chest HRCT showed diffuse ground glass opacities and bilateral pleural effusions. He underwent BAL and TBLB on the first day of admission. Lymphocytes increased and CD4/CD8 ratio was elevated in BALF. TBLB revealed non-caseous epitheloid cell granulomas in the alveolar septa. He immediately received corticosteroid pulse therapy with mPSL of one gram for three days immediately under the diagnosis of acute respiratory failure caused by pulmonary sarcoidosis. He recovered dramatically and pulmonary infiltrates disappeared immediately after the treatment. He had no organ involvement of sarcoidosis except the eyes, lymph nodes and lungs. With no medication for maintenance after mPSL pulse he has had no relapse so far. We reported a rare case of pulmonary sarcoidosis with acute respiratory failure.
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