CHEST Guidelines-A-31-Year-Old-Pregnant-Woman-With-Asthma,-Presenti

A-31-Year-Old-Pregnant-Woman-With-Asthma,-Presenti

Pdf Summary

The document details a case study of a 31-year-old pregnant woman experiencing worsening asthma symptoms that did not respond to standard asthma treatments. Initially believed to be an asthma exacerbation, her symptoms included dyspnea, wheezing, hoarseness, and mild dysphagia. Despite various treatments, including corticosteroids and a bronchodilator, her condition worsened. Physical examinations revealed wheezing predominately in the central airways and other symptoms suggestive of an asthma mimicker.<br /><br />Further investigations, including a CT scan and biopsy, revealed a laryngeal mass, which was identified as HPV-related squamous cell carcinoma. This cancer was causing asthma-like symptoms and was confirmed through histopathological examination demonstrating p16 stain positivity—a marker for HPV involvement. <br /><br />This case emphasizes the importance of considering alternative diagnoses when asthma symptoms persist and do not improve with treatment. Conditions known as asthma mimickers, like GERD, anxiety, or cancers (as seen in this case), can lead to similar respiratory symptoms.<br /><br />Treatment options for the patient involved addressing the cancer. She underwent chemotherapy with plans for radiation therapy post-delivery, and a tracheostomy to manage airway obstruction, which resolved her wheezing. The case highlights the complexities of managing asthma symptoms in pregnancy, particularly when they are caused by a misdiagnosed condition like a laryngeal carcinoma. In young patients, HPV is a notable cause of laryngeal cancer, often detected through positive p16 staining.<br /><br />This case study demonstrates the complexity of diagnosing and treating such conditions during pregnancy, necessitating a multidisciplinary approach to balance maternal health and fetal safety.

Keywords

asthma mimicker

pregnancy

laryngeal carcinoma

HPV-related cancer

squamous cell carcinoma

p16 stain positivity

dyspnea

tracheostomy

multidisciplinary approach

maternal health