Combined Pulmonary Fibrosis and Emphysema in a welder

https://doi.org/10.4081/monaldi.2012.164

Authors

  • R. Roshan Department of Cardiorespiratory Physiology, Vallabhbhai Patel Chest Institute, Delhi, India.
  • M. Gupta Department of Cardiorespiratory Physiology, Vallabhbhai Patel Chest Institute, Delhi, India.
  • R. Kulshrestha Department of Pathology2 Vallabhbhai Patel Chest Institute, Delhi, India.
  • B. Menon Department of Respiratory Allergy and Applied Immunology, Vallabhbhai Patel Chest Institute, Delhi, India.
  • S.K. Chhabra | skchhabra@mailcity.com Department of Cardiorespiratory Physiology, Vallabhbhai Patel Chest Institute, Delhi, India.

Abstract

Combined pulmonary fibrosis and emphysema (CPFE) syndrome is an uncommon entity characterised by emphysema of the upper lobes and diffuse fibrosis of the lower lobes and carries a bad prognosis with the onset of pulmonary hypertension. Lung involvement due to exposures suffered by welders is generally considered benign though, rarely, a diffuse interstitial fibrotic disease has been reported. CPFE syndrome has however never been reported in welders. A 65-year-old man, welder by occupation and an ex-smoker, presented with progressive exertional dyspnoea associated with dry cough noticed for the last four months. On examination, there was mild tachypnea, clubbing and bilateral basal velcro crepitations on chest auscultation. Lung function test revealed mild mixed ventilatory impairment with severe diffusion defect. HRCT chest showed bilateral upper lobe emphysema and diffuse interstitial fibrosis in the lower lobes. Transbronchial lung biopsy revealed interstitial fibrosis, chronic inflammation and iron deposits. A diagnosis of combined pulmonary fibrosis with emphysema (CPFE) with interstitial pulmonary siderofibrosis (IPS) was established. A review of literature did not show any other report of a similar nature.

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Published
2015-12-03
Info
Issue
Section
Case Reports
Keywords:
CPFE syndrome, Interstitial Pulmonary Siderofibrosis, Welding, High resolution computed tomography, Transbronchial lung biopsy.
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How to Cite
Roshan, R., M. Gupta, R. Kulshrestha, B. Menon, and S.K. Chhabra. 2015. “Combined Pulmonary Fibrosis and Emphysema in a Welder”. Monaldi Archives for Chest Disease 77 (1). https://doi.org/10.4081/monaldi.2012.164.

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