1/456. Sequential changes in bronchoalveolar lavage cells and cytokines in a patient progressing from acute to chronic bird fancier's lung disease.A 65-year-old pigeon breeder who presented with acute hypersensitivity pneumonitis refused to give up contact with pigeons and her lung disease, which had initially improved in hospital in response to removal from pigeons, progressed to chronic interstitial fibrosis. bronchoalveolar lavage lymphocytes fell from 50.0% of total cells in December 1986 to 27.1% in February 1990. The ratio of CD4 /CD8 lymphocytes shifted from 0.43 to 1.47. Furthermore, IL-6 and TNF-alpha were elevated initially and were much higher at the second time point. These data pointed to the importance of CD4 lymphocytes, IL-6 and TNF-alpha in the development of pulmonary fibrosis.- - - - - - - - - - ranking = 1keywords = interstitial (Clic here for more details about this article) |
2/456. etoposide-induced pulmonary toxicity.After treatment with etoposide, two patients with lung cancer developed interstitial infiltrates and respiratory failure. Of the two, one patient responded rapidly to steroid therapy and developed recurrent symptoms on re-challenge with etoposide. Both patients had histopathologic findings consistent with drug-induced pulmonary toxicity. etoposide-induced lung disease needs to be considered in patients who develop subacute dyspnea and interstitial infiltrates during treatment with this agent.- - - - - - - - - - ranking = 2keywords = interstitial (Clic here for more details about this article) |
3/456. cyclophosphamide therapy and interstitial pulmonary fibrosis.Intersitial pneumonia and pulmonary fibrosis developed in a 72-year-old man during therapy with cyclophosphamide, vincristine, and prednisone. After extensive investigations, including an open lung biopsy, cyclophosphamide appeared to be the cause of the pulmonary disease. Complete disappearance of tachypnea and the pulmonary infiltrates occurred after the discontinuation of cyclophosphamide and the institution of prednisone therapy. We concluded that the diffuse pulmonary disease in this patient was a result of cyclophosphamide therapy. The clinical and pathologic findings in this case and a review of the literature of cyclophosphamide pulmonary toxicity are reported.- - - - - - - - - - ranking = 4.0645988808348keywords = interstitial, pneumonia (Clic here for more details about this article) |
4/456. Pneumomediastinum, subcutaneous emphysema, and pulmonary fibrosis in a patient with idiopathic pneumonia syndrome after bone marrow transplantation.An adolescent female underwent bone marrow transplantation for relapsed leukemia and developed acute and chronic graft-versus-host disease and idiopathic pneumonia syndrome. Her lung disease responded to large doses of methylprednisolone but evolved to pulmonary fibrosis and pneumomediastinum and subcutaneous emphysema in the convalescent period. Pulmonary function tests revealed a restrictive pattern. Pneumomediastinum and subcutaneous emphysema are complications not only of obstructive but also of restrictive lung disease and vary with respect to time of onset.- - - - - - - - - - ranking = 0.32299440417412keywords = pneumonia (Clic here for more details about this article) |
5/456. pulmonary fibrosis in a steel mill worker.We report a case of pulmonary fibrosis in a 32-year-old man, who had worked at a steel mill and who died of respiratory failure due to interstitial fibrosis despite vigorous treatment. He showed SLE-associated symptoms, such as pleural effusion, malar rashes, discoid rashes, arthritis, leukopenia, and positive antinuclear antibody and anti-histone antibody. However, he did not present anti-dna antibody. A thoracoscopic lung biopsy showed interstitial fibrosis, chronic inflammation and a small non-caseating granuloma in lung tissues, which could be induced by external agents such as metals. The manganese concentration in the lung tissue was 4.64 microg/g compared to 0.42-0.7 microg/g in the controls. The levels of other metals, such as iron, nickel, cobalt and zinc in patient's lung tissue were higher than those in the controls. The patient was probably exposed to Si and various metal dusts, and the lung fibrosis was related to these exposures. Exposure to Si and metal dusts should be sought in the history of any patient with SLE, especially in a male with pulmonary signs, and if present, exposure should be stopped. In the meantime, steps should be taken to ensure that workers exposure to Si and metal dusts in all environments have adequate protection.- - - - - - - - - - ranking = 2keywords = interstitial (Clic here for more details about this article) |
6/456. Coexistent lymphoid interstitial pneumonia, pernicious anemia, and agammaglobulinemia.immunologic factors have been incriminated in the pathogenesis of lymphoid interstitial pneumonia. The discovery of a patient with coexistent lymphoid interestitial pneumonia, pernicious anemia, and common variable hypogammaglobulinemia focused attention on the possible autoimmune nature of this pulmonary disease. Extensive immunologic studies demonstrated a noticeably impaired bonemarrow-dependent (B cell) system and intact thymus-dependent (T cell) system. No evidence of humoral or cellular hypersensitivity to homologous lung determinants was found.- - - - - - - - - - ranking = 31.60730541036keywords = interstitial pneumonia, interstitial, pneumonia (Clic here for more details about this article) |
7/456. Persistent pneumomediastinum in interstitial fibrosis associated with rheumatoid arthritis: treatment with high-concentration oxygen.We present a case of persistent spontaneous pneumomediastinum precipitated by an upper respiratory infection in a patient with interstitial fibrosis associated with rheumatoid arthritis who was receiving chronic corticosteroid treatment. The persistent nature of the mediastinal emphysema over 2 months eventually required treatment with high concentrations of inhaled oxygen that resulted in rapid resolution of the pneumomediastinum without recurrence over 6 months of follow-up. This case, along with others in the medical literature, emphasizes the need for early use of high-concentration inhaled oxygen in the treatment of pneumomediastinum in high-risk patients, such as those with connective tissue disorders.- - - - - - - - - - ranking = 5keywords = interstitial (Clic here for more details about this article) |
8/456. Rheumatoid disease without arthritis.A middle-aged man developed multiple subcutaneous rheumatoid granulomata, high titer of rheumatoid factor, diffuse interstitial pulmonary fibrosis and digital clubbing in the absence of clinicoradiological evidence of synovial disease. This patient supports the concept of rheumatoid disease without arthritis.- - - - - - - - - - ranking = 1keywords = interstitial (Clic here for more details about this article) |
9/456. The diagnosis of brain depression in the presence of severe multisystem disease--a case study.Brain depression in a patient with severe multisystem disease can be a diagnostic challenge, particularly when the patient is maintained on artificial life-support systems. A case report is presented of a 13-year-old girl with severe pneumonia who was treated with prolonged cardiopulmonary bypass during which time she developed a clinical picture simulating brain death with marked depression of cerebral cortical activity on two successive EEGs. Following correction of some of her metabolic defects, the patient showed marked improvement of cortical function. Multisystem disease can be so severe as to produce a clinical picture of brain death. We wish to emphasize that brain hypofunction of depression is best evaluated by both clinical examination and the EEG, and that neither one alone is sufficient to conclude that cerebral death has occurred.- - - - - - - - - - ranking = 0.064598880834825keywords = pneumonia (Clic here for more details about this article) |
10/456. Hard metal lung disease--the first case in singapore.INTRODUCTION: We report the first case of hard metal lung disease in singapore and the occupational investigative work and control measures that were undertaken. CLINICAL PICTURE: A 38-year-old machinist in the tool manufacturing industry presented with exertional dyspnoea and cough. Chest X-ray revealed bilateral reticulonodular infiltrates with honeycombing. High resolution computed tomography scan of the thorax confirmed the presence of interstitial fibrosis. Open biopsy of the lung showed features of pneumoconiosis. Particle induced X-ray emission (PIXE) analysis, a relatively new elemental analysis technique, performed on the lung biopsy specimen confirmed the presence of tungsten and titanium; and he was diagnosed to have hard metal lung disease. Microbiologic, serologic and histologic investigations excluded an infective cause. Serial pulmonary function tests on follow-up showed no progression. He presented with haemoptysis 10 months later and was diagnosed to have tuberculosis on the basis of positive sputum and bronchoalveolar lavage cultures for mycobacterium tuberculosis complex. TREATMENT: Preventive measures and permanent transfer to non-cobalt work were instituted. OUTCOME: The interstitial fibrosis appears to have stabilised. CONCLUSION: The diagnosis of hard metal lung disease must be considered in a worker exposed to cobalt presenting with interstitial fibrosis.- - - - - - - - - - ranking = 3keywords = interstitial (Clic here for more details about this article) |
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