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Idiopathic fibrosing mediastinitis with esophageal varices: A case report

Abid M Sadiq1,2, Faryal M Raza1,2, Yazid R Abdulrahimu1

  • 1Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Heliyon
|May 5, 2023
PubMed

Insights

Fibrosing mediastinitis (FM) is a rare lung fibrosis cause. This case highlights its varied symptoms and the importance of differential diagnosis when the etiology remains unidentified.

Area of Science:

  • Pulmonology
  • Radiology
  • Gastroenterology

Background:

  • Fibrosing mediastinitis (FM) is a rare condition causing lung fibrosis.
  • Etiologies include infections (histoplasmosis), IgG4-related disease, and idiopathic causes.
  • Prompt diagnosis is crucial for effective management.

Observation:

  • A 55-year-old male presented with esophageal varices, hiccups, and dyspnea.
  • Initial chest X-ray suggested SARS-CoV-2 sequelae or metastasis.
  • CT imaging confirmed fibrosing mediastinitis.

Findings:

  • The patient's variceal bleeding was managed.
  • The underlying cause of FM was not identified, delaying specific treatment.
  • Corticosteroids may not halt disease progression; surgery is an option for persistent symptoms.

Implications:

  • Idiopathic FM necessitates thorough exclusion of other diagnoses through laboratory and imaging studies.
  • Accurate etiological identification is key for targeted FM treatment.
  • This case underscores the diagnostic challenges and management considerations for fibrosing mediastinitis.
Keywords:
Case reportComputed tomographyEsophageal varicesFibrosing mediastinitisIdiopathicIgG4

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