title: Reversible platypnea-orthodeoxia syndrome induced by rapidly progressive interstitial pneumonia in a patient with polymyositis.
abstract: We report a case of platypnea-orthodeoxia that developed in a 64-year-old Japanese woman during an episode of rapidly progressive interstitial pneumonia with polymyositis. Pulmonary infiltrates were predominant in the bilateral lower lobes. The patient was treated successfully with early administration of immunosuppressive therapies and polymyxin B-immobilized fiber column-direct hemoperfusion, and her platypnea-orthodeoxia improved with resolution of the underlying parenchymal lung disease. Reports of platypnea-orthodeoxia syndrome with interstitial pneumonia are extremely rare. The recognition that platypnea-orthodeoxia syndrome may occur in multiple disease states, including interstitial pneumonia, is crucial to the understanding of this perplexing disorder.
authors.affiliation: Department of Internal Medicine, Division of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital Chiba, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yamakawa
authors.affiliation: Department of Internal Medicine, Division of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital Chiba, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Internal Medicine, Division of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital Chiba, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Baba
authors.affiliation: Department of Internal Medicine, Division of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital Chiba, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Ishikawa
authors.affiliation: Department of Internal Medicine, Division of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital Chiba, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takagi
authors.affiliation: Department of Internal Medicine, Division of Respiratory Medicine, Jikei University School of Medicine Tokyo, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kuwano
keywords: Hypoxemia; platypnea-orthodeoxia syndrome; polymyositis; rapidly progressive interstitial pneumonia; ventilation/perfusion mismatch