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We present a 50-year-old woman with progressive dyspnea, cough, and nasal congestion. Evaluation revealed positive skin tests (IgE) to trees and dust mites, early glottic closure on spirometry, and sinus opacities on CT. Diagnostic considerations included allergic and nonallergic rhinitis, asthma, aspirin-exacerbated respiratory disease, vocal cord dysfunction, chronic sinusitis secondary to gastroesophageal reflux disease, and systemic inflammatory and immunologic diseases, including vasculitis. Progresson of her symptoms prompted further investigation, and a biopsy yielded an unexpected diagnosis.

Citation

Jacqueline A Ross, William J McCune, Georgiana Sanders. A 50-year old woman with nasal congestion, cough, and dyspnea. Allergy and asthma proceedings : the official journal of regional and state allergy societies. 2013 Mar-Apr;34(2):188-92

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PMID: 23484897

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