BMJ Case Reports 2017; doi:10.1136/bcr-2017-223147
  • Images in…

Critical pitfall: another cause of wheezing

Open Access
  1. Hajime Takizawa
  1. Respiratory Medicine, Kyorin university, Mitaka, Japan
  1. Correspondence to Dr Takeshi Saraya, sara{at}
  • Accepted 25 October 2017
  • Published 8 November 2017


An 87-year-old woman was referred to our hospital with progressive dyspnoea on effort over the previous 2 weeks. She had been treated for rheumatoid arthritis with oral prednisolone (5 mg/day) and tacrolimus (2 mg/day). At her first visit, vital signs and physical examination were normal except for slight rhonchi in anterior lung fields. Chest radiograph showed slight cardiomegaly, but no abnormal lesions were noted in either lung (figure 1A). Echocardiography demonstrated no evidence of congestive heart failure. She …

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