Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency
Basilar predominant emphysema, or disproportionate emphysematous involvement of the lung bases compared to the apices, is an uncommon radiographic pattern of emphysema traditionally associated with alpha-1-antitrypsin deficiency (AATD). We present a case of a 59-year-old female with 41 pack-year tob...
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Wiley
2022-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2022/9840085 |
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| author | Ho-Man Yeung Lauren Gaffaney |
| author_facet | Ho-Man Yeung Lauren Gaffaney |
| author_sort | Ho-Man Yeung |
| collection | DOAJ |
| description | Basilar predominant emphysema, or disproportionate emphysematous involvement of the lung bases compared to the apices, is an uncommon radiographic pattern of emphysema traditionally associated with alpha-1-antitrypsin deficiency (AATD). We present a case of a 59-year-old female with 41 pack-year tobacco use, Stage IV COPD with supplemental oxygen, and bibasilar predominant emphysema who successfully underwent bronchoscopic lung volume reduction. She presented with recurrent hospitalizations for frequent exacerbations. After lung reduction, the patient displayed improvement in functional status without hospitalizations at the 15-month follow-up. Careful history taking is essential for any patients diagnosed with lower lobe emphysema to elucidate the underlying etiology. This case challenges the notion that basilar emphysema is sensitive or specific for AATD and emphasizes that this pattern of emphysema has a broad differential diagnosis and alternative etiologies should be considered. Our patient was ultimately diagnosed with smoking-related emphysema, with atypical bibasilar involvement. Furthermore, basilar predominant emphysema should be considered a separate entity from its apical predominant counterpart. |
| format | Article |
| id | doaj-art-37066b2bfde345ff82eab709fe6d76cc |
| institution | Kabale University |
| issn | 1687-9635 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-37066b2bfde345ff82eab709fe6d76cc2025-02-03T00:59:36ZengWileyCase Reports in Medicine1687-96352022-01-01202210.1155/2022/9840085Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin DeficiencyHo-Man Yeung0Lauren Gaffaney1Department of MedicineDepartment of MedicineBasilar predominant emphysema, or disproportionate emphysematous involvement of the lung bases compared to the apices, is an uncommon radiographic pattern of emphysema traditionally associated with alpha-1-antitrypsin deficiency (AATD). We present a case of a 59-year-old female with 41 pack-year tobacco use, Stage IV COPD with supplemental oxygen, and bibasilar predominant emphysema who successfully underwent bronchoscopic lung volume reduction. She presented with recurrent hospitalizations for frequent exacerbations. After lung reduction, the patient displayed improvement in functional status without hospitalizations at the 15-month follow-up. Careful history taking is essential for any patients diagnosed with lower lobe emphysema to elucidate the underlying etiology. This case challenges the notion that basilar emphysema is sensitive or specific for AATD and emphasizes that this pattern of emphysema has a broad differential diagnosis and alternative etiologies should be considered. Our patient was ultimately diagnosed with smoking-related emphysema, with atypical bibasilar involvement. Furthermore, basilar predominant emphysema should be considered a separate entity from its apical predominant counterpart.http://dx.doi.org/10.1155/2022/9840085 |
| spellingShingle | Ho-Man Yeung Lauren Gaffaney Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency Case Reports in Medicine |
| title | Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency |
| title_full | Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency |
| title_fullStr | Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency |
| title_full_unstemmed | Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency |
| title_short | Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency |
| title_sort | basilar predominant emphysema thinking beyond alpha 1 antitrypsin deficiency |
| url | http://dx.doi.org/10.1155/2022/9840085 |
| work_keys_str_mv | AT homanyeung basilarpredominantemphysemathinkingbeyondalpha1antitrypsindeficiency AT laurengaffaney basilarpredominantemphysemathinkingbeyondalpha1antitrypsindeficiency |