DIPNECH: The neuroendocrine enigma behind persistent respiratory symptoms in the post-COVID era
Year: 2025
Type: article
Abstract: Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) is an underrecognized lung disease that hides in plain sight, often misdiagnosed as asthma or COPD. Its early symptoms such as chronic cough, wheezing, and dyspnea are deceptively nonspecific, leading to diagnostic delays even in patients with classic risk factors like middle-aged, non-smoking females. In one illustrative case, a woman developed unexplained respiratory symptoms following COVID-19, eventually leading to a diagnosis of DIPNECH after incidental imaging revealed pulmonary nodules. The hallmark feature is airway-centered neuroendocrine cell proliferation, which can exist with or without tumorlets or progression to carcinoid tumors. Though symptoms may respond to bronchodilators or corticosteroids, unchecked progression may result in irreversible airflow obstruction. Recognizing DIPNECH early is crucial for timely intervention. When common diagnoses do not fully explain the clinical picture, DIPNECH deserves a place on the differential. • Rare and often misdiagnosed pulmonary disorder that mimics asthma and COPD, leading to significant diagnostic delays. • Significant improvement of chronic cough with asthma treatments, underscoring the potential benefits of corticosteroids and bronchodilators in symptom management. • Robotic bronchoscopy confirmed a neuroendocrine tumorlet, highlighting the need for precise tissue sampling, while successful robotic wedge resection is crucial for preventing disease progression.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,200
OpenAlex ID: W4414559690