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bipedal and scrotal swelling for 2 weeks. He was diagnosed as having silicosis in 2014 but had continued exposure. Examination revealed that elevated jugular venous pressure, tender hepatomegaly with pedal oedema. He was haemodynamically stable with pulmonary hypertension (PHT). Respiratory examination revealed bilateral fine end inspiratory fine crepitation mostly in the upper and mid zones without lymphadenopathy. Patient had a type I respiratory failure and improved with non-invasive ventilation. The chest X-ray was suggestive of interstitial fibrosis with predominant mid and upper zones. 2D-echocardiography revealed severe PHT with right ventricular failure. Inflammatory markers, full blood count, liver and renal functions were within normal limits with albumin of 38 g/l and serum creatinine of 0.6 mg/dl. Serum calcium level and Angiotensin converting enzyme levels were also within normal limits. Anti-nuclear antigen, Rheumatoid factor and Antineutrophil cytoplasmic antibodies (ANCA) levels were negative. Sputum for acid fast bacilli and tuberculosis GeneXpert were negative. The high resolution computed-tomography (HRCT) showed progressive bilateral upper lobe scarring, reticul

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Publisher

John Wiley and Sons; Wiley (Blackwell Publishing); Blackwell Publishing Inc.; Wiley (ISSN 1323-7799)

Published

2019

Language

EN

Field

Medicine (Health Sciences)