title: Lung scan in the diagnosis and management of patent foramen ovale pulmonary embolism, paradoxical embolism.
abstract: This case illustrates the reopening of foramen ovale in a young patient with chronic pulmonary hypertension caused by bronchiectasis and chronic pulmonary fibrosis, which resulted in a prominent right-to-left shunt and severe hypoxia. Her clinically unsuspected right-to-left shunt was discovered during ventilation-perfusion scan, which was performed for the evaluation of pulmonary embolism. She had common variable immune deficiency, a primary immunodeficiency disease in which B-lymphocytes produce few or no antibodies. Most patients with this syndrome have an intrinsic defect in their B-lymphocytes that results in reduced immunoglobulin production. In these patients, recurrent respiratory tract infections are common and may result in chronic lung disease, fibrosis, particularly bronchiectasis (20-30%) and even cor pulmonale as happened in our patient [J. Clin. Immunol. 9 (1989) 22-33.].
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, 601 North Caroline Street, OPC, Suite 3235, Baltimore, MD 21287-0817, USA. accivelek@jhmi.edu
authors.forename: A Cahid
authors.initials: AC
authors.lastname: Civelek
authors.forename: Elcin
authors.initials: E
authors.lastname: Ozalp
authors.forename: Bernard L
authors.initials: BL
authors.lastname: Gerber
authors.forename: James
authors.initials: J
authors.lastname: Weiss
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000150:complications*; D017074:Common Variable Immunodeficiency / Q000150:complications; D003937:Diagnosis, Differential; D018618:Echocardiography, Doppler, Color; D017809:Fatal Outcome; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging