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Case 276
Corentin Delhaye1, Michel Walsdorff1, Maxime Hackx1
1From the Department of Radiology, CHU Brugmann, Place A. Van Gehuchten 4, 1020 Brussels, Belgium (C.D., M.W.); and Department of Radiology, CHR Haute Senne, Soignies, Belgium (M.H.).
Radiology
|November 22, 2019
Summary
This case study highlights a 34-year-old man with progressive shortness of breath and weight loss, presenting a diagnostic challenge. Investigations revealed significant pulmonary function abnormalities, including reduced diffusing capacity for carbon monoxide.
Area of Science:
- Pulmonary Medicine
- Diagnostic Imaging
- Internal Medicine
Background:
- A 34-year-old male presented with progressive dyspnea and productive cough.
- He reported significant unintentional weight loss over four months.
- Physical examination revealed bilateral clubbing and hypoxemia.
Purpose of the Study:
- To present a case of unexplained shortness of breath and weight loss.
- To outline the diagnostic workup for complex pulmonary symptoms.
- To discuss potential underlying etiologies based on clinical and imaging findings.
Main Methods:
- Clinical history and physical examination.
- Laboratory tests including complete blood count and arterial blood gas analysis.
- Pulmonary function tests (PFTs) and chest imaging (radiography and CT scan).
Main Results:
- Hypoxemia (oxygen saturation 87%) and partially compensated pulmonary alkalosis.
- Pulmonary function tests showed normal spirometry but reduced diffusing capacity for carbon monoxide (60%).
- Chest imaging findings were detailed (Figs 1-3).
Conclusions:
- The patient's presentation suggests a significant underlying pulmonary pathology.
- Further investigation is warranted to determine the cause of reduced diffusing capacity and hypoxemia.
- This case underscores the importance of comprehensive evaluation in patients with unexplained respiratory symptoms.

