Abstract
We report the case of an 8-years-old girl with recurrent pulmonary infections and wheezing since infancy, in whom asthma and immunoglobulin-G deficiency were diagnosed at the age of 7 months. Since then, the patient was treated for asthma without any satisfactory control of the disease. Cardiomegaly was finally diagnosed radiologically that led to cardiac assessment. Echocardiography suggested left sided partial anomalous pulmonary venous return that was not confirmed at angio-computed tomography scan and cardiac magnetic resonance imaging. Instead, total absence of the pericardium with relative left lung hypoplasia and left-sided bronchiectasis was diagnosed. Immune defect was confirmed. Adequate treatment by immunoglobulin supplementation and observance of the recommended care of bronchiectasis allowed favorable evolution. This case of an unusual association between an exceptional pericardial malformation and immune deficiency causing lower respiratory tract infections complicated by leftsided bronchiectasis highlights the absolute necessity to explore further any child with insufficient asthma control.
Highlights
An 8-year-old girl was referred to our department following the discovery of cardiomegaly on the chest X-ray during recent exploration for recurrent lower respiratory infections
The left lung was partially compressed by the leftwards-displaced heart, and showed a hypoventilation of the lower lobe with left-sided posterobasal bronchiectasis (Figure 1). This diagnosis of total absence of pericardium was confirmed by a cardiac magnetic resonance imaging (MRI) performed in supine, left- and right lateral position (Figure 2)
Total absence of the pericardium is a The atrial septum was intact in all its por- allergic asthma and intensive respiratory rare affection with an incidence of tions
Summary
An 8-year-old girl was referred to our department following the discovery of cardiomegaly on the chest X-ray during recent exploration for recurrent lower respiratory infections. Because of a cardiac murmur and was considered normal Since she showed recurrent wheezing and - lower respiratory tract infections. The left lung was partially compressed by the leftwards-displaced heart, and showed a hypoventilation of the lower lobe with left-sided posterobasal bronchiectasis (Figure 1). This diagnosis of total absence of pericardium was confirmed by a cardiac magnetic resonance imaging (MRI) performed in supine, left- and right lateral position (Figure 2).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
