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12 January 2021: Articles

Ptosis and Miosis Associated with Fibrosing Mediastinitis

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease

Shakeel Ahmed A* , Mansoor Hameed E , Merlin M. Thomas E , Khezar S. Syed E , Irfan U. Haq F , Abbas AlAbbas D

DOI: 10.12659/AJCR.927556

Am J Case Rep 2021; 22:e927556

Table 1. Fibrosing mediastinitis subtypes and characteristic features.

Granulomatous (Focal) FM 80–90% of cases (more common)Nongranulomatous (Diffuse) FM 10–20% of cases (less common)
Associated with:SarcoidosisTuberculosisOther Fungal InfectionsAssociated with:Autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, Bechet disease)RadiationIgG4 diseaseDrugs (methysergide)
Cough, dyspnea, hemoptysis, recurrent pneumonia, no extrathoracic symptomsCough, dyspnea, recurrent pneumonia, hemoptysis, extrathoracic symptoms possible depending on the other organ systems involved
Focal localized mass in the paratracheal, subcarinal, or hilar region with dense or stippled calcificationsDiffuse infiltrative soft-tissue masses in the mediastinumCalcifications rare
Signs of previous infections like histoplasmosis, e.g. calcified granulomasRetroperitoneal fibrosis, sclerosing cholangitis, features of other associated autoimmune conditions

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923