PulmPEEPs 82. Fellows’ Case Files: UMass Chan
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Aug 22, 2024 Join third-year PCCM fellows Jen Kodela and Ariel McKenna from UMass Chan as they tackle a complex respiratory case involving a 75-year-old woman with intricate medical challenges. They share insights on the diagnostic dilemmas surrounding PL12 antisynthetase syndrome and discuss innovative treatment strategies, including the role of rituximab. The fellows also highlight the supportive and flexible nature of their fellowship program, showcasing the collaborative learning environment that fosters medical education.
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Initial Presentation and History
- A 75-year-old woman presented with acute-on-chronic shortness of breath, cough, left-sided chest pain, and rash.
- Despite multiple antibiotic courses and asthma therapy, her symptoms progressed over several months.
Significance of Eosinophilia and Oxygen Requirement
- An acute illness requiring new home oxygen always warrants further investigation.
- Eosinophilia in a bacterial pneumonia context is unusual, suggesting alternative diagnoses like eosinophilic pneumonia or vasculitis.
Imaging Recommendations for ILD Workup
- Use chest CT to evaluate lung parenchyma and adenopathy.
- Consider high-res CT with inspiratory and expiratory films to assess lung volumes and air trapping, particularly in suspected ILD.