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Swyer-James-Macleod Syndrome in a Geriatric Patient: a Case Report

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Abstract

Hyperlucent lung syndrome or Swyer-James-Macleod syndrome is a rare, often incidental finding, primarily showing unilateral hyperlucency as a consequence of bronchiolitis obliterans. Often diagnosed in early childhood, though in some cases, it may only be discovered in adulthood or on account of recurrent chest infections. An 88-year-old patient presented to our outpatient center with complaints of shortness of breath with mild to moderate exertional dyspnea and exacerbations of symptoms classically associated with chronic obstructive pulmonary disease. Complaints have persisted for several years with waxing and waning intensity. There is a history of migraine, atrial fibrillation, hypothyroidism, and colon and breast cancer without recurrence. Computed tomography of the chest with intravenous contrast showed asymmetric emphysematous changes with marked hyperinflation and attenuated vasculatures confined to the middle lobe of the right lung. The patient was started on a combination of inhaled long-acting beta-agonists, corticosteroids, and long-acting muscarinic antagonists and is almost asymptomatic. Geriatric patients are at increased risk of various age-related diseases, respiratory disorders being among them. Knowledge of this rare condition allows for its appropriate management as it often coexists with bronchiectasis and results in frequent respiratory infections, which may be preventable.

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Abbreviations

CT:

Computed tomography

SJS:

Swyer-James syndrome

PFT:

Pulmonary function test

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Authors and Affiliations

  1. Department of Medicine, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India

    Ishita Panchal

  2. Department of Medicine, Smt. N.H.L. Municipal Medical College and SVPISMR, Ahmedabad, Gujarat, India

    Abhi Shah

  3. Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

    Subham Bhowmik

  4. Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan

    Rimsha Rahim Vohra

  5. Department of Pulmonary Medicine, Houston Methodist Hospital, Houston, TX, USA

    Kim Bloom

  6. Department of Pulmonary Critical Care, Houston Methodist Hospital, Houston, TX, USA

    Kenneth Scott Lloyd

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Contributions

Conceptualization: IP, AS, RV, SB, KB, KL.

Drafting of the manuscript: IP, AS, RV, SB.

Critical revision: IP, AS, KB, KL.

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Correspondence to Abhi Shah.

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Panchal, I., Shah, A., Bhowmik, S. et al. Swyer-James-Macleod Syndrome in a Geriatric Patient: a Case Report. SN Compr. Clin. Med. 5, 249 (2023). https://doi.org/10.1007/s42399-023-01595-w

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