Exertional dyspnea and hemoptysis in an adolescent: is it tuberculosis only?

Abstract

Unilateral pulmonary artery atresia (UPAA), commonly detected in childhood, can occasionally present in adulthood with typical symptoms of recurrent pulmonary infections, dyspnoea on exertion and hemoptysis. An 18-year-old girl presented with complaints of cough, dyspnea on exertion and hemoptysis. Chest radiograph revealed dilated pulmonary trunk, signs of left sided volume loss and cavitating lesion in left lower zone. Pulmonary CT angiography found left pulmonary artery atresia. Endobronchial lung biopsy revealed granulomatous inflammation. Diagnosis of left sided UPAA with pulmonary tuberculosis was established. She responded well to the anti-tubercular therapy. This case highlights the importance of awareness about UPAA as a possible differential for exertional dyspnea, recurrent chest infections, hemoptysis and pulmonary hypertension in adults.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

Pfefferkorn JR, Löser H, Pech G, et al. Absent pulmonary artery. A hint to its embryogenesis. Pediatr Cardiol 1982;3:283-6.

Ten Harkel ADJ, Blom NA, Ottenkamp J. Isolated unilateral absence of a pulmonary artery: a case report and review of the literature. Chest 2002;122:1471-7.

Steiropoulos P, Archontogeorgis K, Tzouvelekis A, et al. Unilateral pulmonary artery agenesis: a case series. Hippokratia 2013;17:73-6.

Smith NE, Fabian T, Nabagiez J. Unilateral pulmonary artery atresia in an adult: A case report. Respir Med Case Rep 2019;26:105-7.

Bouros D, Pare P, Panagou P, et al. The varied manifestation of pulmonary artery agenesis in adulthood. Chest 1995;8:670-6.

Vyas P, Oswal N, Patel I. Burden of congenital heart diseases in a tertiary cardiac care institute in Western India: Need for a national registry. Heart India 2018;6:45.

Zhang LZ, Ma WG, Gao SG, He J. Unilateral absence of pulmonary artery associated with contralateral lung cancer. J Thorac Di. 2016; 8:E942-6.

Moosavi SAJ, Iranpour A. Unilateral pulmonary artery agenesis in an adult patient with cough and hemoptysis: A case report. Tanaffos 2014;13:58-60.

Bockeria LA, Makhachev OA, Khiriev TKh, Abramyan MA. Congenital isolated unilateral absence of pulmonary artery and variants of collateral blood supply of the ipsilateral lung. Interact CardioVasc Thorac Surg 2011;12:509-10.

Wang P, Yuan L, Shi J, Xu Z. Isolated unilateral absence of pulmonary artery in adulthood: clinical analysis of 65 cases from a case series and systematic review. J Thorac Dis 2017;9:4988–96.

Seedat F, Kalla IS, Feldman C. Unilateral absent pulmonary artery in an adult - A diagnostic and therapeutic challenge. Respir Med Case Rep 2017;22:23-42.

van der Merwe PL, Kalis N, Schaaf HS, et al. Risk of pulmonary tuberculosis in children with congenital heart disease. Pediatr Cardiol 1995;16:172-5.

Harris KM, Lloyd DC, Morrissey B, Adams H. The computed tomographic appearances in pulmonary artery atresia. Clin Radiol 1992;45:382–6.

Mimura S, Kobayashi H, Shinkai M, et al. A case report of congenital isolated absence of the right pulmonary artery: bronchofibrescopic findings and chest radiological tracings over 9 years. Respirology 2005;10:250–3.

Komatsu Y, Hanaoka M, Ito M, et al. Unilateral absence of the pulmonary artery incidentally found after an episode of hemoptysis. Int Med 2007;46:1805–8.

Published
2021-02-02
Info
Issue
Section
Pneumology - Case Reports
Keywords:
Pulmonary atresia, pulmonary hypertension, computed tomography angiography
Statistics
  • Abstract views: 117

  • PDF: 48
How to Cite
Goel, N., Goyal, N., & Kumar, R. (2021). Exertional dyspnea and hemoptysis in an adolescent: is it tuberculosis only?. Monaldi Archives for Chest Disease, 91(1). https://doi.org/10.4081/monaldi.2021.1613

Most read articles by the same author(s)