Universität zu Köln

Schreiber, Tina, Brockmann, Michael, Gossmann, Axel, Kosse, Nils Juriaan, Stoelben, Erich and Windisch, Wolfram (2021). SARCOIDOSIS INVOLVEMENT OF THE DIAPHRAGM LEADING TO RIGHT DIAPHRAGMATIC ELEVATION: A CASE REPORT. Sarcoidosis Vasc. Diffus. Lung Dis., 38 (2). FIDENZA: MATTIOLI 1885. ISSN 1124-0490

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Abstract

A 69-year-old male Caucasian presenting with dyspnea on exertion related to unilateral diaphragmatic dysfunction as caused by sarcoidosis is described. First, right diaphragmatic elevation was unexplained, while the patient presented with a restrictive pattern in lung function testing using bodyplethysmography and with reduced global and diaphragmatic respiratory muscle strength as evidenced by respiratory pressures. Subsequently, surgical diaphragm plication was performed, unfortunately, without any clinical improvement. Microscopic examination of diaphragm sections revealed a lymphocytic myositis with granulomatous pleuritis showing multiple non-caseating epithelioid granulomas. Accordingly, a lymphocytic alveolitis (26% lymphocytes) with an elevated CD4/CD8 T cell ratio of 8.0% and elevated serum parameters (neopterin and sIL-2 receptor) were established. Consequently, the diagnosis of pulmonary sarcoidosis with diaphragm involvement but without extrapulmonary involvement has been established. Therefore, sarcoidosis needs to be considered in any patient presenting with unilateral diaphragmatic dysfunction. The optimal treatment strategy, however, needs to be established in the future.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schreiber, Tina UNSPECIFIED UNSPECIFIED UNSPECIFIED Brockmann, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Gossmann, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kosse, Nils Juriaan UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoelben, Erich UNSPECIFIED UNSPECIFIED UNSPECIFIED Windisch, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-570416
DOI:	10.36141/svdld.v38i2.8042
Journal or Publication Title:	Sarcoidosis Vasc. Diffus. Lung Dis.
Volume:	38
Number:	2
Date:	2021
Publisher:	MATTIOLI 1885
Place of Publication:	FIDENZA
ISSN:	1124-0490
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RESPIRATORY MUSCLE INVOLVEMENT Multiple languages Respiratory System Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57041