Dyspnea in a Patient with Asthma, Interstitial Lung Disease, and Dermatomyositis

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Siu Yu Zoe Lau
Lawrence Jacobs

Dyspnea, Asthma, Interstitial Lung Disease, Dermatomyositis

Abstract


We describe the case of a 32-year-old woman with interstitial lung disease (ILD) secondary to dermatomyo-sitis and severe asthma who presented with 2 months of progressive dyspnea and hypoxemia while on rituximab, prednisone, and omalizumab. No clear etiology of her worsening symptoms was identified on previous presentations to care. Repeat CT chest revealed bilateral cystic lung changes and ground glass opacities. She was found to have Pneumocystis jirovecii pneumonia (PJP). This case highlights PJP as an important cause of dyspnea to consider in immunosuppressed patients with these radiographic findings.



Résumé
Nous décrivons le cas d’une femme de 32 ans atteinte d’une pneumopathie interstitielle consécutive à une der-matomyosite et à un asthme grave et qui présente une dyspnée et une hypoxémie progressives depuis deux mois. Elle prend du rituximab, de la prednisone et de l’omalizumab. Aucune étiologie claire de l’aggravation de ses symptômes n’a été cernée lors de ses visites précédentes. Une nouvelle tomodensitométrie des poumons révèle des modifications kystiques bilatérales des poumons et des opacités en verre dépoli. Il s’avère qu’elle est atteinte d’une pneumonie à Pneumocystis jirovecii (PPJ). Ce cas met en évidence la PPJ comme étant une cause importante de dyspnée à considérer chez les patients immunodéprimés présentant de tels résultats radiographiques.

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