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Case Report
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| Systemic to pulmonary arteriovenous fistula in a patient with tuberculosis sequels: A sign of inflammatory neoangiogenesis | ||||||
| Maria Fernanda Saavedra1, Maria Juliana Valenzuela2, Monica Ocampo3, Carlos Garavito4, José Federico Saaibi5, Mauricio Orozco-Levi6 | ||||||
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1MD, Respiratory Department Attending Physician, Respiratory Department, Fundación Cardiovascular de Colombia (FCV), Floridablanca, Santander, Colombia.
2MD, Hemodynamics Department Attending Physician, Hemodynamics Department, Fundación Cardiovascular de Colombia (FCV), Floridablanca, Santander, Colombia. 3MD, Radiology Department Chief, Radiology Department, Fundación Cardiovascular de Colombia (FCV), Floridablanca, Santander, Colombia. 4MD, Thorax Surgery Department Chief, Thorax surgery Department, Fundación Cardiovascular de Colombia (FCV), Floridablanca, Santander, Colombia. 5MD, Hemodynamics Department Chief, Hemodynamics Department, Fundación Cardiovascular de Colombia (FCV), Floridablanca, Santander, Colombia. 6MD, PhD, Respiratory Department Chief, Respiratory Department, Fundación Cardiovascular de Colombia (FCV), Floridablanca, Santander, Colombia, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia, Universitat Pompeu Fabra, and CIBER of Respiratory Diseases, Spain. | ||||||
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| Saavedra MF, Valenzuela MJ, Ocampo M, Garavito C, Saaibi JF, Orozco-Levi M. Systemic to pulmonary arteriovenous fistula in a patient with tuberculosis sequels: A sign of inflammatory neoangiogenesis. Int J Case Rep Images 2015;6(1):34–38. |
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Abstract
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Introduction:
The study of the causes of hemoptysis entails multiple diagnostic choices and tests. However, in 30% of the cases, a cause is not clearly identified (cryptogenic hemoptysis). Even though pulmonary arteriovenous malformations are uncommon, they must be taken into account as possible causes of hemoptysis. Particularly, acquired systemic-to-pulmonary vascular fistulas are atypical and represent both diagnostic and therapeutic challenges.
Case Report: We describe a case of systemic to pulmonary arteriovenous malformation between the internal mammary and right subclavian arteries to the upper lobe pulmonary veins, in a 47-year-old male with a past history of pulmonary tuberculosis who presented with hemoptysis. The patient had received anti-tuberculous treatment in another institution after he was diagnosed with pulmonary tuberculosis made conclusive by positive smear tests and chest radiologic examination. He was subsequently treated on a second occasion in spite of the negative smears following the first treatment because of the persistent hemoptysis. Despite recurrent hemoptysis, the patient was brought to our institution six years after the beginning of the hemoptysis. Pulmonary arteriography was done revealing a right internal mammary and subclavian arteriovenous malformation in communication with the vessels of the right upper pulmonary lobe, which was successfully treated with endovascular embolization. Conclusion: We believe systemic to pulmonary fistulas can represent a sign of inflammatory pulmonary and extrapulmonary neoangiogenic process. | |
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Keywords:
Acquired arteriovenous fistula, Hemoptysis, Inflammatory neoangiogenesis, Internal mammary artery, Tuberculosis
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Author Contributions
Maria Fernanda Saavedra – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Maria Juliana Valenzuela – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Monica Ocampo – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Carlos Garavito – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published José Federico Saaibi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published. Mauricio Orozco-Levi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published. |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 Maria Fernanda Saavedra et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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