A 50-year-old man with stage 2 sarcoidosis with pleural involvement.
We present a case of a 50-year-old man who presented with progressive shortness of breath, cough, chest pain, and weight loss. His computer tomography (CT) scan of the chest showed a left-sided pleural effusion, subpleural and peribronchovascular nodules, bilateral hilar and mediastinal lymphadenopaties. Traasbronchial biopsies of the lung parenchyma and Video-Assisted Thoracoscopic Surgery (VATS) with pleural biopsies revealed the presence of noncaseating granulomas. A diagnosis of stage 2 sarcoidosis with pleural involvement was made and treatment with prednisone was started. The patient continued with persistent dyspnea and a left-sided pleural effusion. Steroid treatment was tapered and leflunomide therapy was initiated. A significant improvement of his clinical condition was seen after 1 month on treatment.
Modrykamien
Ariel
A
Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland OH 44195, USA. modryka@ccf.org
Arrossi
Andrea
A
Reddy
Anita
A
D018501:Antirheumatic Agents / Q000627:therapeutic use; D004417:Dyspnea / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use; D000077339:Leflunomide; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use*; D012507:Sarcoidosis / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D007555:Isoxazoles; D000077339:Leflunomide; D011241:Prednisone