COPD with PAOD - respiratory problem. 

PATIENT NAME : ARUP DUTTA

Sex : Male Age : 21 years Height : 5ft 9 inch Weight : 43 Kg Food habit : Non-veg Education : Persuading B. Tech. 3rd Yr. Father’s Name : Mother’s Name :

Address : Nabapally Circular Road, P.O. Nabapally, P.S. Barasat, Dist. North 24 Parganas West Bengal – 700126. Email : ar***utta188@gmail.com Phone : 09###448630/90###50539

Present Status of the Patient :

Arup Dutta, 21 year male, is suffering from severe SOB from the age of 8 years with associated recurrent cough and nasal congestion. His symptoms are so severe that he has to use Inhaler e.g. Duolin, Budecort combination approximately two packs of 200 puffs each per day.

History of past illness :

A. In the year 1998 the patient went to CMCH, Vellore (Child Health unit) for treatment and subsequently he was admitted and investigations were done, the summery of positive findings of the reports were as follows :

• Chest X-Ray : Increased bronchovascular markings with reticular nodular shadowing. Thickening of minor fissure. • Lung Biopsy : Diffused infiltrate of lymphocyte with plate forming lymphoid aggregates - Chronic interstitial pneumonitis

After these findings he was treated mainly with Terbutaline Inhalation.

Final Diagnosis by CMCH, Vellore :

• Chronic interstitial pneumonitis • ?? Collagen Vascular Disease

B. In the year 2003, January, the patient again went to CMCH, Vellore (Child Health unit) for further treatment and he was subsequently a PFT was done and found to have restrictive lung disease pattern and diagnosed as suffering from Pulmonary Haemosiderosis.

Treatment : The patient was started with oral Prednisolone within which there was both clinical and radiological improvement, hence steroids were tapered to minimal dose.

Final Diagnosis by CMCH, Vellore:

• Pulmonary Haemosiderosis.

C. From 2003, May to 2011, July the patient was treated under Dr. Parthasarathi Bhattacharyya, (Consultant Pulmonologist, MD, DNBE, DM). He diagnosed the patient as suffering from ?? Chronic Indolent infection with superadded bronchospasm, Chronic interstitial pneumonitis. The patient was then treated mainly with inhaler (e.g. Aerocort, Foracort, Asthalin etc.) In the mean time the following tests were carried out as per advice of the doctor : Bone marrow study was done with no significant findings. Alpha – 1 – Antitrypsin Quantitation : 172.00 mg/dl. Chest X-Ray shows hyperinflatted lung fields with emphysematous changes at right upper and mid zone, hila normal, costophrenic angles clear, domes of diaphragm are normal, cardiac size normal., Blood counts within normal limit.

D. On August 9, 2011, the patient was treated by Dr. Amit Sengupta after sudden bout of SOB. The significant clinical findings – Chest – ronchi ++, Creps - - , The suggested medicines mainly are Combilide 250 / Asthalin MDI , tab sterio 16, tab telekarol-L etc. – small improvement noted. The patient was advised to consult Dr. Joydip Deb, MD-Pulmonogist.

E. On September 24, 2011, the patient met Dr. Joydip Deb. HRCT was carried out. The findings were as follows: • Digital X-Ray shows evidence of bilateral emphysematous change • Lung : Evidence of predominantly panaciner emphysematous change mixed with centriaciner and bullous emphysematous change at places, seen in both lung fields, involving all lobes alongwith evidence of mosic attenuation at places. • COPD with PAOD. • No obvious focal S.O.L. or pulmonary nodule seen. A few marginally bronchiectatic change seen • No evidence of any ILD seen

The doctor suggested to take inhaler, nebulisation and mouthpaint