case_images: PMC10228224_01
case_images: PMC10228224_02
case_images: chest computed tomography scan at age 22 years, as well as multiple scans during follow up over the years. The scan at age 33 years was made when the patient presented to the emergency department with COVID-19. (a) Bilateral consolidations that are not well circumscribed, multiple nodules, fissural and pleural irregularities and multiple ground glass areas. Diffuse thickening of bronchial walls. Overall appearance suggestive of granulomatous disease. (b) Disappearance of multiple consolidations, and appearance of multiple new consolidations and ground glass abnormalities. (c) Disappearance of some consolidations in the lower fields, but appearance of new consolidations in the upper fields. (d) Disappearance of some consolidations and appearance of new consolidations and ground glass. (e) New consolidation in the left lower lobe. (f) Impressive progression of bronchiectasis in the left lower lobe, disappearance and appearance of consolidation and ground glass. (g) New consolidations and ground glass, mainly in the lower fields. (h) Pneumothorax on the left side, increase in ground glass and consolidations in both lungs. (i) Increase in pneumothorax on the left side, mediastinal shift to the right, increased bronchiectasis in the middle lobe. (j) Increased air in left upper lobe.
case_images: CRII2023-3977739.001.jpg
case_images: PMC10228224_02_CRII2023-3977739.001.jpg
case_images: fig1
case_images: On chest computed tomography (CT) scans, multiple consolidations and ground glass areas were seen in the lower fields, as well as pleural and fissural irregularities, most consistent with a granulomatous disease (Figure 1(a); further CT-imaging in the course of the patient's life is provided in Figures 1(b)-1(j)). A CT-scan of the chest was performed, which revealed pre-existent bronchiectasis with new consolidations and ground glass abnormalities in the lower fields (Figure 1(f)). A chest CT scan showed persistent ground glass abnormalities in both lungs, in addition to a small left-sided pneumothorax and a right-sided consolidation (Figure 1(g)).
case_images: (a) CTLA4 expression in CD25+ FOXP3+ T-cells within CD4+ population in our patient (in red), as well as healthy controls (in blue, green, and yellow). (b) ICOS expression in CD25+ FOXP3+ T-cells within CD4+ population in our patient and healthy controls. (c) Expression in CD25+ FOXP3+ T-cells within CD4+ population in our patient and healthy controls. (d) Expression in CD25+ FOXP3+ T-cells within CD4+ population in our patient and healthy controls.
case_images: CRII2023-3977739.002.jpg
case_images: PMC10228224_02_CRII2023-3977739.002.jpg
case_images: fig2
case_images: T-cells. The mean fluorescence intensity of CTLA-4 on our patients' regulatory T-cells was 1057, which was lower than the 95% confidence interval calculated for healthy controls (2038-3191, Figure 2).