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Crippled lung: variations on a theme by Macleod

J Quintero, E W Swenson, M Arborelius

    European Journal of Respiratory Diseases
    |August 1, 1980
    PubMed
    Summary
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    This study identifies "crippled lung" syndrome in nine male patients with abnormally small lungs, often linked to childhood respiratory infections. These patients exhibit chronic bronchitis, airway obstruction, and reduced lung perfusion, requiring management of infection tendencies.

    Area of Science:

    • Pulmonary Medicine
    • Radiology
    • Cardiology

    Background:

    • Investigated patients with unilateral small lung presenting radiographic and physiologic abnormalities.
    • Examined clinical history, including childhood pneumonia/bronchiolitis and chronic bronchitis.
    • Assessed symptoms such as exertional dyspnea.

    Observation:

    • Nine male patients (18-68 years) with unilateral small lungs (3 right, 6 left).
    • Radiography revealed hypolucency (2) or hyperlucency (7).
    • Bronchography showed bilateral chronic bronchitis (all) and bronchiectasis (3).
    • Angiography demonstrated diminished vascularity to the smaller lung.
    • Spirometry indicated airway obstruction (7).
    • All patients had pulmonary arterial hypertension.

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    Findings:

    • The smaller lung had reduced ventilation (30%) and significantly lower perfusion (15%).
    • Radiospirometry showed extremely slow xenon-133 washout in radiolucent areas.
    • Pulmonary arterial hypertension was a consistent finding.
    • Chronic bronchitis and airway obstruction were prevalent.

    Implications:

    • Proposed the descriptive term "crippled lung" syndrome to encompass clinical variants without implying etiology.
    • Highlighted the commonality of clinical or subclinical bronchitis.
    • Emphasized the therapeutic goal of combating airway infection tendencies.