Dr. Fanny Wai-San Ko, Dr. Wing-Ho Yip, 20180815064342
Although a majority of patients can achieve good asthma control with the use of inhaled corticosteroid (ICS) and bronchodilators, some patients’ asthma remain uncontrolled despite the use of these medications.
The syndrome of sensory neuronopathy and detection of anti-Hu antibody in 2010 were very strong indications of the presence of a malignant tumour. In a series of 200 patients positive for anti-Hu, 83.5 percent were found to have cancer, and 90 percent of the cancer cases were small-cell lung cancer.
An 82-year-old lady with hypertension and hyperlipidaemia presented with 2 weeks’ history of increasing breathing difficulty. She had flu-like illness 2 weeks ago with some residual dry cough. Physical examination showed low-grade fever of 37.8°C with mildly elevated jugular venous pressure and mild pedal oedema. There was no obvious murmur, and chest auscultation revealed bilateral basal crepitations. Her blood pressure was 130/80 mm Hg. She required oxygen 1 L/min to maintain blood oxygen saturation level (SpO2) of 94 percent.