A Case of Sarcoidosis Listed for Lung Transplantation

DOI
  • Ichikawa Hirohisa
    Okayama University Medical School Hematology, Oncology and Respiratory Medicine
  • Hiramatsu Junichi
    Okayama University Medical School Hematology, Oncology and Respiratory Medicine
  • Tanimoto Yasusi
    Okayama University Medical School Hematology, Oncology and Respiratory Medicine
  • Kanehiro Arihiko
    Okayama University Medical School Hematology, Oncology and Respiratory Medicine
  • Tanimoto Mitsune
    Okayama University Medical School Hematology, Oncology and Respiratory Medicine
  • Date Hiroshi
    Okayama University Medical School Cancer and Thoracic Surgery
  • Shimizu Nobuyoshi
    Okayama University Medical School Cancer and Thoracic Surgery
  • Kataoka Mikio
    Okayama University Medical School Faculty of Health Sciences
  • Nakata Yasunari
    Okayama University Medical School Faculty of Health Sciences

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Other Title
  • 肺移植登録をしているサルコイドーシスの一例

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Abstract

We report a case of a 53-year-old man who was found to have chest abnormal shadow in a general examination and diagnosed as having Sarcoidosis by TBLB. He was treated with prednisolone for 6 months, but the chest abnormal shadow did not improve. Because he had no respiratory symptom, he did not go to the hospital. In 1992, he suffered from dyspnea when exerting himself and he has been treated with prednisolone (5-20mg/day) from that time on. In March 1994, he became ill of pneumothorax and the dyspnea got worse. In May 2000, home oxygen therapy (HOT) was begun and non-invasive positive pressure ventilation (NIPPV) was started in August 2001. In January 2002, he wanted to receive a lung transplant and came to the department of cancer and thoracic surgery in our hospital. Chest x-ray and CT showed severe constriction, linear shadow, bullous change in bilateral lung and pleural thickening. With regard to pulmonary functions, he demonstrated a restrictive pattern (VC0.831, %VC22.6%, FEV1.0% 79.5%). Arterial gas finding was PaO2 57.5torr, PaCO2 67.8torr (O2 1.251/min). Six minute walk test was 150m (O2 1.251/mm). Suffering from progressive lung sarcoidosis unresponsive to medical treatment, he had been receiving HOT and NIPPV. Because it is thought that his prognosis is poor and he has no other organ failure except the lungs, his advanced disease was considered to be appropriate for lung transplantation, and we registered him on the list for lung transplantation.

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