Acute and Critical Care

Case Reports

Pulmonary
Successful Immunoglobulin Treatment in Severe Cryptogenic Organizing Pneumonia Caused by Dermatomyositis: Dong Hoon Lee, Jee Hyun Yeo, Young Il Kim, Seung Jun Gim, Jang Won Sohn, Ji Young Yhi; Korean J Crit Care Med. 2015;30(3):212-217. Published online August 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.3.212

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In connective tissue diseases, autoantibodies cause pulmonary interstitial inflammation and fibrosis, and patients require treatment with an immunosuppressive agent such as a steroid. Dermatomyositis is an incurable, uncommon form of connective tissue disease that occasionally causes diffuse pulmonary inflammation leading to acute severe respiratory failure. In such cases, the prognosis is very poor despite treatment with high-dose steroid. In the present case, a 46-year-old man was admitted to our hospital with dyspnea. He was diagnosed with dermatomyositis combined with cryptogenic organizing pneumonia (COP) with respiratory failure and underwent treatment with steroid and an immunosuppressive agent, but the COP was not improved. However, the respiratory failure did improve after treatment with intravenous immunoglobulin, which therefore can be considered a treatment option in cases where steroids and immunosuppressive agents are ineffective.

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A Case Report of Steroid-Resistant Cryptogenic Organizing Pneumonia Managed with Intravenous Immunoglobulins
Christian Akem Dimala, Urvi Patel, Benjamin Lloyd, Anthony Donato, William B. Kimmel, Robert Hallowell, Caitlyn Moss, Tun-Chieh Chen
Case Reports in Pulmonology.2021; 2021: 1. CrossRef

Five Successful Experiences in the Treatment of Charcoal Aspiration with Bronchoscopic Toilet: A Case Report: Young Il Kim, Jae Seok Park, Jae Sung Choi, Sung Shik Jou, Hyo Wook Gil, Sae Yong Hong; Korean J Crit Care Med. 2012;27(3):202-206.; DOI: https://doi.org/10.4266/kjccm.2012.27.3.202

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Abstract PDF: Although activated charcoal is an effective treatment for most toxic ingestions, aspiration of activated charcoal can be fatal. Here, we report that in 5 charcoal aspiration cases, bronchoscopy with suction and lavage was an effective way to remove charcoal from the lungs. Patients showed high APACHE II scores (range: 10-29), and either low PO2 levels, or low CO2 retention. After bronchoscopic removal of the aspirated charcoal, symptoms of hypoxia, CO2 retention, localized wheezing, and pneumonic infiltration as determined by chest radiography, improved in most patients. We report 5 cases of successful treatment of charcoal aspiration with bronchoscopic toilet.

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