1/12. Nosocomial pneumonia likely caused by stenotrophomonas maltophilia in two patients with polymyositis.We report two cases of polymyositis (PM) complicated with nosocomial pneumonia probably caused by stenotrophomonas maltophilia, which was resistant to multiple antimicrobials. In the first case, the chest CT findings and high serum endotoxin level as well as sputum culture results were helpful for the proper diagnosis and the therapy was successful. However the second patient died of a lung abscess in spite of the intensive antibiotic therapy. When PM patients develop pneumonia unresponsive to various antibiotics, a multi-drug-resistant bacteria such as stenotrophomonas maltophilia should be considered as the pathogen.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/12. breast cancer shortly after the diagnosis of interstitial pneumonia associated with polymyositis.polymyositis is sometimes associated with pulmonary fibrosis or malignant diseases, however, rarely with both simultaneously. For such patients, no criterion for initial treatment and tapering of steroid has been reported. We describe a patient who had breast cancer and interstitial pneumonia associated with polymyositis. In this case, slow tapering of the steroid was an important aspect of the treatment, and close clinical follow-up was necessary to monitor for disease exacerbation.- - - - - - - - - - ranking = 0.83333333333333keywords = pneumonia (Clic here for more details about this article) |
3/12. polymyositis, pulmonary fibrosis and malignant lymphoma associated with hepatitis c virus infection.polymyositis has been associated with various viral infections, and a spectrum of immune-related diseases may occur with hepatitis c (HCV) infection. Both polymyositis and HCV infection may be accompanied by pulmonary fibrosis. An association between polymyositis and malignancy has also been reported. We report a 55-year-old woman accompanied cryoglobulinemia with HCV infection and manifesting polymyositis, pulmonary fibrosis and malignant lymphoma. Steroid therapy was effective to improve interstitial pneumonia, polymyositis, and liver function.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
4/12. Fatal acute interstitial pneumonitis complicating polymyositis in a 41-year-old man.We report a case of a previously healthy 41-year-old man who was admitted for progressive dyspnea and cough, which culminated in respiratory failure, shock, and death. Lung and muscle biopsy results were consistent with interstitial lung disease secondary to polymyositis. polymyositis and dermatomyositis are rare autoimmune diseases that primarily affect the muscles and skin, with frequent extramuscular and specifically pulmonary manifestations. Respiratory complications are in 2 categories: primary (the interstitial lung diseases, which can be acute or chronic) and secondary (aspiration pneumonia/pneumonitis, muscle weakness, infection, drug-induced disease, pulmonary congestion secondary to heart failure, pulmonary hypertension, and pneumomediastinum). diagnosis of a specific interstitial lung disease relies mainly on high-resolution computed tomography of the chest and on tissue diagnosis. prognosis depends on the histopathology findings and the specific form of interstitial lung disease and its response to therapy, which consists of high-dose steroids and immunomodulating agents. Unfortunately, patients with polymyositis/dermatomyositis associated with pulmonary complications have a worse prognosis than patients with isolated forms.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
5/12. hemosiderin deposits in chronic graft-vs.-host disease related myopathy.Chronic graft-vs.-host disease (cGVHD) occurs in 20-50% of patients who survive for at least 100 d after allogeneic stem cell transplantation (SCT). cGVHD includes scleroderma-like skin changes, chronic cholangitis, obstructive lung disease and general wasting syndrome. polymyositis or myopathy are rare manifestations of cGVHD with approximately 40 reported cases. polymyositis accompanied by hemosiderin deposits in cGVHD has been reported only once, and there are no reports on lipofuscin deposits in skeletal muscle cells in cGVHD. We report here on a 56-yr-old male who underwent allogeneic SCT in 1999 for osteomyelofibrosis and progressive hematopoietic insufficiency. In February 2004, the patient was hospitalized for progressive muscular weakness with loss of the ability to walk. Laboratory tests demonstrated normal values for serum creatine kinase, aldolase and lactic dehydrogenase; the ferritin level was highly elevated. The femoral muscle biopsy showed mostly perifascicular atrophy as well as numerous subsarcolemmal hemosiderin and lipofuscin deposits. Intravenous administration of the chelating agent deferoxamine was ineffective. Three weeks later the patient died of aspiration pneumonia. Interestingly, autopsy disclosed moderate hemosiderin deposits in the liver, the organ usually involved in hemosiderosis.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
6/12. Choroidopathy with serous retinal detachment in a patient with polymyositis.PURPOSE: The authors report a unique case of multifocal choroidopathy in association with polymyositis. methods: The clinical presentation, laser treatment, and subsequent change in ocular findings are described. RESULTS: A 65-year-old Japanese man with polymyositis experienced mid acute vision impairment in both eyes during systemic corticosteroid treatment for interstitial pneumonia. Fundus examination revealed a gray-white subretinal exudate with serous retinal detachment. Angiographic examination disclosed partial dilatation of the choroidal vein at the posterior pole and dye leakage points in the retinal pigment epithelium. The patient's left eye developed bullous retinal detachment and multi focal choroidal nodules at the posterior pole during the period of tapering of oral corticosteroid administration. Retinal burns were applied to the dye leakage points in the right eye using an argon laser. Vision in the right eye showed rapid recovery due to regression of the serous retinal detachment. However, in the left eye without retinal burns visual acuity decreased to light perception only even after regression of the bullous retinal detachment and choroidopathy. CONCLUSIONS: In serous retinal detachment with choroidopathy associated with polymyositis, laser photocoagulation at leakage points may be useful for rapid restoration of vision and for the prevention of permanent severe vision loss.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
7/12. Pulmonary capillaritis and diffuse alveolar hemorrhage. A primary manifestation of polymyositis.polymyositis is often complicated by either usual interstitial pneumonitis, diffuse alveolar damage, cellular interstitial pneumonitis, or bronchiolitis obliterans-organizing pneumonia. Pulmonary capillaritis, a distinct interstitial reaction associated with diffuse alveolar hemorrhage, occurs with the systemic vasculitides and some collagen vascular diseases. It has not been described in patients with polymyositis. We describe two patients who developed a relatively acute onset of polymyositis based on the appearance of a severe proximal myopathy, elevated serum creatine phosphokinase levels, compatible electromyographic abnormalities, inflammatory muscle biopsies, and in one case, the presence of serum anti-Jo-1 antibodies. Concomitant with their muscle disease, they developed respiratory failure that proved to be pulmonary capillaritis with varying degrees of diffuse alveolar hemorrhage as well as bronchiolitis obliterans-organizing pneumonia. Although those reactions are reported to occur with other collagen vascular diseases, these two cases are the first reports of pulmonary capillaritis and diffuse alveolar hemorrhage complicating polymyositis.- - - - - - - - - - ranking = 11.311171022969keywords = bronchiolitis obliterans, bronchiolitis, obliterans, pneumonia (Clic here for more details about this article) |
8/12. bronchiolitis obliterans organizing pneumonia in polymyositis. A case report with longterm survival.In 1973, a 36-year-old black woman with dyspnea on exertion, Raynaud's phenomenon and arthralgia was first seen at the University of california at los angeles Medical Center. Her chest roentgenography showed bilateral basilar infiltration, open lung biopsy revealed bronchiolitis obliterans with organizing pneumonia (BOOP) and muscle biopsy was consistent with inflammatory myopathy. She has been followed for 18 years, has responded well to conservative treatment, initially with alternate day prednisone, with added azathioprine for the past 8 years, and remained fully employed. The favorable prognosis of this case is consistent with that of the BOOP category proposed by Tazelaar, et al in 1990. We conclude that a careful histological subclassification is suggested before initiating aggressive therapy in patients with polymyositis and interstitial lung disease.- - - - - - - - - - ranking = 7.9765602296706keywords = bronchiolitis obliterans, bronchiolitis, obliterans, pneumonia (Clic here for more details about this article) |
9/12. polymyositis and sjogren's syndrome associated with bronchiolitis obliterans organizing pneumonia.bronchiolitis obliterans organizing pneumonia (BOOP) occurred in a 53-year-old woman with well-documented sjogren's syndrome (SjS) and polymyositis (PM). BOOP has often been reported as a pulmonary manifestation of collagen vascular diseases, mainly rheumatoid arthritis (RA), but the association of BOOP and PM has rarely been documented. A search of the literature showed only 16 case reports of BOOP associated with polymyositis-dermatomyositis (PM-DM). It is interesting that BOOP occurred prior to PM-DM, while it is commonly believed to occur after RA.- - - - - - - - - - ranking = 23.202585725485keywords = bronchiolitis obliterans, bronchiolitis, obliterans, pneumonia (Clic here for more details about this article) |
10/12. bronchiolitis obliterans organizing pneumonia as the first manifestation of polymyositis.bronchiolitis obliterans organizing pneumonia (BOOP) preceding polymyositis is rare. In this report, a 51-year-old patient with fever, nonproductive cough, and dyspnea had bilateral basal interstitial infiltrates on chest roentgenogram. Open lung biopsy was consistent with BOOP. prednisone therapy led to improvement, but 8 weeks later, fever, cough, and weakness of the arms and legs developed because the patient had not been compliant with the prednisone regimen. The creatine kinase (CK), the macrophage inflammatory protein (MIP-1), and the tumor necrosis factor (TNF-alpha) were elevated. Anti-Jo-1 antibody was not present. Quadriceps femoris muscle biopsy was compatible with polymyositis. After a second course of corticosteroid therapy, the patient became afebrile, the dyspnea resolved, the pulmonary infiltrates decreased, and the muscle strength improved. The serum CK, MIP-1, and TNF-alpha levels declined significantly. This is only the second reported case of BOOP preceding polymyositis. patients with idiopathic BOOP should have follow-up for the possible development of connective tissue disorders including polymyositis.- - - - - - - - - - ranking = 2.9012183977325keywords = obliterans, pneumonia (Clic here for more details about this article) |
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