title: Challenges in the classification of fibrotic ILD: Patient case 2.
abstract: PATIENT PRESENTATION AND DIAGNOSTIC WORK-UP: The patient is a 72-year-old man presenting with dyspnoea on exertion. He is a former heavy smoker (40 pack-years) and his father, now deceased, had rheumatoid arthritis (RA). On physical examination he had mild bi-basilar crackles but no finger clubbing. Autoimmune serology was positive for rheumatoid factor (RF: 25 IU/ml). Lung function tests showed normal FVC, a FEV1/FVC ratio of 72% and a TLCO of 49% predicted. Lung CT showed centrilobular and paraseptal emphysema, subpleural fine reticulation and traction bronchiolectasis, with no clear basal predominance (Figure 1). BAL cytology showed 83% alveolar macrophages, 12% lymphocytes, 3% neutrophils, and 2% eosinophils.
authors.affiliation: Department of Pulmonary Disease, Erasmus Medical Centre, University Hospital Rotterdam, The Netherlands. redazione@mattioli1885.com.
authors.forename: Marlies
authors.initials: M
authors.lastname: Wijsenbeek
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D001707:Biopsy, Needle; D001999:Bronchoscopy / Q000379:methods; D003937:Diagnosis, Differential; D018450:Disease Progression; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D017809:Fatal Outcome; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy; D007150:Immunohistochemistry; D008297:Male; D011656:Pulmonary Emphysema / Q000175:diagnosis* / Q000209:etiology; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000305:Adrenal Cortex Hormones