Possible DDX of Constrictive Bronchiolitis with other findings

Posted by 5333 @5333, 21 hours ago

I had an acute shortness of breath episode 5 months ago that happened two days after my Cosentyx injection for Axial Psoriatic Arthritis. Many urgent care/ER/Primary care doc visits. No high white count/no fevers/no congestion. It was debilitating. Saw cardiologist - did 14 day heart monitor-found inappropriate sinus tachycardia possibly due to dysautonomia and was given Corlanor. That helped the breathing a lot but not completely. Did an echo; no major problems found. Then went to National Jewish Health - they found new onset vocal cord dysfunction and their cardiologist found mild pulmonary hypertension. Have a sleep doctor also, saw her twice; did an overnight oximetry test - overnight oxygen and sleep apnea well treated. Did a broncholavage which came back abnormal due to low BAL return. No infection found, but infection occurred from the broncholavage and so NJH gave me two weeks of 250 Zithromax daily and steroids. They also found gastritis (I cough up mucus immediately when I eat certain foods). I started taking an over the counter mast cell medication while waiting for some results since I was still short of breath although it improved a bit with the corlanor. The chromium sodium mast cell spray ended the gastritis symptoms/stopped the coughing up mucus after eating completely. Also, I have random facial severe flushing at times for no reason. The chromium sodium spray after couple days has ended that too. The pulmonologist though - who I have not seen for two months - is not willing to look at my sleep doctors tests nor is he willing to consider anything since I saw him and he is wanting to do a trial for constrictive bronchiolitis of high dose steroids and antibiotics. I am diabetic - not on insulin. I also cannot take antibiotics - history of antibiotic resistant C-Diff. I am lost in all this. I have CT findings of severe small vessel injury and so that is why they think constrictive bronchitis. I am not sure what to do now. My breathing is a lot better now with only the addition of coplanar and mast cell spray. Any ideas or referrals to pulmonology possibly at Mayo would be appreciated.

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