• Logo
  • SBMUJournals

Lifelong Idiopathic Unilateral Diaphragmatic Paralysis With Recurrent Pneumonia: A Case Report

Khosrow Agin, Akram Sabkara, Farzaneh Sadat Mirsafai Rizi ‎, Bita Dadpour, Maryam Vahabzadeh, Babak Mostafazadeh




A 50-year-old woman was admitted to the emergency center with dyspnea, cough, and fever symptoms. She had a medical history of diabetes mellitus type II, rheumatoid arthritis, as well as several admission records due to aspiration pneumonia. The primary diagnosis was diabetic ketoacidosis and pneumonia. Normal breath sounds were reduced on the lower posterior right side of the thorax. A standard chest x-ray and lung Computed Tomography (CT) scan revealed collapse consolidation in the Right Lower Lobes (RLL) and Right Middle Lobes (RML). We here presented a case of unilateral diaphragmatic paralysis with a history of recurrent pneumonia.


Diaphragmatic paralysis, Pulmonary atelectasis, Pneumonia, Diabetic ketoacidosis


Kokatnur L, Rudrappa M. Diaphragmatic palsy. Diseases. 2018; 6(1):pii:E16. [DOI:10.3390/diseases6010016] [PMID] [PMCID]

Nason LK, Walker CM, McNeeley MF, Burivong W, Fligner CL, Godwin JD. Imaging of the diaphragm: Anatomy and function. Radiographics. 2012; 32(2):E51-70. [DOI:10.1148/rg.322115127] [PMID]

Koo CW, Johnson TF, Gierada DS, White DB, Blackmon S, Matsumoto JM, et al. The breadth of the diaphragm: Updates in embryogenesis and role of imaging. The British Journal of Radiology. 2018; 91(1088):20170600. [DOI:10.1259/bjr.20170600] [PMID] [PMCID]

Kocjan J, Gzik-Zroska B, Nowakowska K, Burkacki M, Suchoń S, Michnik R, et al. Impact of diaphragm function parameters on balance maintenance. PLOS One. 2018; 13(12):e0208697. [DOI:10.1371/journal.pone.0208697] [PMID] [PMCID]

Ricoy J, Rodríguez-Núñez N, Álvarez-Dobaño JM, Toubes ME, Riveiro V, Valdés L. Diaphragmatic dysfunction. Pulmonology. 2019; 25(4):223-35. [DOI:10.1016/j.pulmoe.2018.10.008] [PMID]

Bains KNS, Lappin SL. Anatomy, Thorax, Diaphragm. New York: StatPearls; 2019.

Troyer AD, Wilson TA. Action of the diaphragm on the rib cage. Journal of Applied Physiology. 2016; 121(2):391-400. [DOI:10.1152/japplphysiol.00268.2016] [PMID]

Kokatnur L, Rudrappa M. Diaphragm, Disorders. StatPearls. New York: StatPearls Publishing; 2019.

Elefteriades J, Singh M, Tang P, Siegel MD, Kenney B, Pandey A, et al. Unilateral diaphragm paralysis: Etiology, impact, and natural history. The Journal of Cardiovascular Surgery. 2008; 49(2):289-95. [PMID]

Steier J, Jolley CJ, Seymour J, Kaul S, Luo YM, Rafferty GF, et al. Sleep-disordered breathing in unilateral diaphragm paralysis or severe weakness. European Respiratory Journal. 2008; 32(6):1479-87. [DOI:10.1183/09031936.00018808] [PMID]

Vetrugno L, Guadagnin GM, Barbariol F, Langiano N, Zangrillo A, Bove T. Ultrasound imaging for diaphragm dysfunction: A narrative literature review. Journal of Cardiothoracic and Vascular Anesthesia. 2019; 33(9): 2525-36. [DOI:10.1053/j.jvca.2019.01.003] [PMID]

Benditt JO. Esophageal and gastric pressure measurements. Respiratory Care. 2005; 50(1):68-75. [PMID]

McCool FD, Tzelepis GE. Dysfunction of the diaphragm. The New England Journal of Medicine. 2012; 366(10):932-42. [DOI:10.1056/NEJMra1007236] [PMID]

DOI: https://doi.org/10.32598/ijmtfm.v9i4.26743