COVID-19,sarcoidosis,inflammation

Parsonage–Turner syndrome (PTS) is a peripheral inflammatory neuropathy of unknown etiology. We present a rare case of a 50‐year‐old male patient with PTS post‐COVID‐19 BNT162b2 mRNA vaccine. Symptoms occurred 15 days after the second dose. He was treated with corticosteroids, analgesics, and physical rehabilitation with a partial recovery.

Idiopathic tracheal stenosis (Idio-SS) is an extremely rare disease. Its diagnosis is of exclusion and could be misdiagnosed as asthma. Herein, we report the case of a 39-year-old woman who had been treated for asthma for several months. She has no history of endotracheal intubation or granulomatous disease. Flexible fiberoptic bronchoscopy and thoracic computed tomography revealed double tracheal stenosis. The patient had rigid bronchoscopy; the upper tracheal stenosis was dilated with insertion of a silicone airway stent at the level of the distal stenosis. The diagnosis of idiopathic stenoses was made according to the clinico-radiological features. Symptoms were completely relieved and no recurrence was observed after one year of follow-up. This case highlights the importance of clinical suspicion and early diagnosis of Idio-SS in patients with unexplained wheezing and dyspnea. It also illustrates the role of endoscopic procedures in this situation.

Background: Children with sickle cell anemia (SCA) are at an increased risk of cardiovascular complications. The aim of this study was to assess the role of speckle tracking echocardiography in detecting subclinical myocardial damage in children with SCA. Methods: A cross-sectional case–control study was conducted at the echocardiography laboratory of the military hospital of Tunis between July and December 2018. Thirty patients with SCA were included. A control(C) group including 30 normally developing children was selected and matched to the SCA group by sex and age. We compared between the two groups: conventional echocardiographic parameters including cardiac output, left ventricular ejection fraction (LVEF), thickness and the global longitudinal strain (GLS). The echocardiographic measurements were indexed according to body surface area. The left ventricular (LV) GLS association with clinical characteristics and echocardiographic parameters were also evaluated. Results: Patients and controls were matched for age and sex: the mean age was (11± 2years) in SCA group versus (12± 1 years) in C group with a sex ratio of (1.31 versus 1.27, respectively). Body surface area was comparable. LV hypertrophy and dilation were revealed in the SCA group, whereas measurements were normal in the C group. No significant differences were observed for cardiac output (p=0.4). LVEF were preserved in both groups. However, two-dimensional (2D) LVGLS was impaired in 46% of SCA group (n=14) with mean value of (-21%±3.07 vs -25%±2.98; p<0.01).In SCA group, impaired LVGLS was significantly associated with LV mass (r = – 0.399, p<0.01), LV tele diastolic diameter(r= -0.419, p<0.01) and left atrial volume (r= - 0.399, p< 0.04). In multivariate analysis, LV mass was the only independent factor. Conclusions: In the present study, LVGLS measurement revealed subclinical LV systolic impairment in patients with SCA. Therefore, 2D strain could be beneficial to detect the natural history of LV dysfunction in SCA.

Tracheobronchial endoluminal hamartochondroma (HC) is a rare benign tumor, most frequently diagnosed in individuals between the sixth and seventh decades of life. The clinical presentation is usually very noisy. Here, we report two interesting cases. The first patient is a 58-year-old man who was wrongly treated for chronic obstructive pulmonary disease. HC was in the lower third of the trachea. The second patient is a 43-year-old man with a history of bronchiectasis and right lower lobectomy. HC was in the middle lobe bronchus. The resection via rigid bronchoscopy with diode laser was successful without any complications. Only one patient keeps a small stable tumor residue. The rigid bronchoscopy with laser-application in tracheobronchial endoluminal HC is safe and effective. Flexible bronchoscopy is important during the follow-up.

Introduction: Interstitial lung diseases(ILDs)encompass a wide and varied range of parenchymal pulmonary disorders. Comorbidities can pre-exist or develop at any time during the course of the disease. Prognostication in ILDs remains challenging, and the relationship between comorbidities and survival has yet to be characterized. Objective: The aim of this study was to describe the relationship between comorbid conditions and survival in patients with various ILDs. Methods: A retrospective study including 69 hospitalized patients between June and December 2020 for acute exacerbations of fibrosing ILDs in Pneumology department of Hedi Chaker hospital Sfax Tunisia. We compared 2 groups:G1(patients with comorbidities, n=42) and G2 (patients without comorbidities, n=27). Results: Mean age was 63 years in G1 vs 61 years inG2. Twenty five patients with idiopathic pulmonary fibrosis were included in this study. The mean number of comorbidities was1.6(≥2 comorbidities in 21cases(50%)). Most frequent comorbidities groups was non respiratory comorbidities included arterial hypertension(18cases), diabetes(15cases) and coronary heart disease(6cases). Respiratory comorbidities were lung cancer(4cases)and chronic obstructive pulmonary disease(COPD)(4cases). Long-term oxygen therapy was prescribed in 28% in G1 vs 24%G2, p=0.7). Deceased patients had more co-morbidities than survivors(5%G1 vs 4%G2, p=0.83). Acute exacerbations appear to be more common in patients with comorbidities (1.74 G1vs 1.00 G2, p=0.001). These patients had also the longest stays in hospital(24.5 days on average vs 19.4, p=0.6). Conclusion: Early identification and accurate treatment of comorbidities is essential. It can help determine the prognosis in ILDs.