A healthy female adolescent with idiopathic scoliosis who presented with recurrent dyspnea and wheezing: a case report

A 15-year-old female adolescent visited our hospital’s outpatient and emergency departments several times due to recurrent paroxysmal dyspnea for 6 months. Based on the clinical symptoms, the researchers empirically diagnosed bronchial asthma and treated the patient with oral steroids and inhaled corticosteroid agents; however, her symptoms did not significantly improve. As part of the differential diagnosis, thoracic scoliosis was observed in previous chest X-ray images. The patient’s records from 2018 (patient age, 10 years) and 2023 (patient age, 15 years) showed that scoliosis had progressed during her rapid growth period). As the symptoms did not improve despite ongoing medication, further evaluation was performed. Contrast-enhanced chest computed tomography revealed a thoracic eighth vertebral body compressing the right bronchus intermedius. The patient rarely wore the existing brace due to discomfort, but a new custom brace was prescribed based on chest computed tomography findings. Since then, the patient’s compliance with treatment increased and she gradually increased the amount of time she wears the brace. In addition, her Cobb’s angle and pulmonary function tests improved in outpatient follow-up visits. The patient’s recurrent dyspnea and wheezing were originally considered to be an asthma exacerbation, prompting treatment with medication, but the symptoms did not improve. Therefore, clinicians should be careful to keep in mind the possibility of other diseases in patients who visit the hospital with typical asthma symptoms, such as dyspnea or wheezing—especially growing adolescents—in order to avoid delaying diagnosis or treatment.