Cases reported "Pleurisy"

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1/7. mycobacterium avium complex pleuritis accompanied by diabetes mellitus.

    A 72-year-old woman with diabetic nephropathy was hospitalized with peripheral edema in the extremities and weight increase. After diuretics and human serum albumin administration, her condition improved. From the 15th day she had run a subfever and her breathing was diminished in the left lower lung field. A plain chest x-ray film showed pleural effusion over the left lung field. The fluid was exudative. Fluid cultures were negative. A tuberculin reaction was negative. polymerase chain reaction method disclosed mycobacterium avium complex, indicating rare pleuritis due to mycobacterium avium complex. Eighteen days after chemotherapy, pleural effusion disappeared. Although her hemoglobin A1c (HbA1c) levels were maintained from 6.0 to 6.5% over 4 years, urinary albumin excretion levels and serum creatinine levels increased, indicating deteriorating diabetic nephropathy. serum albumin levels remained low (3.3-3.6 g/dl). malnutrition, impaired cellular immunity and apparently abnormal microvascular circulation due to diabetes mellitus may consequently have induced pleuritis due to mycobacterium avium complex.
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ranking = 1
keywords = mycobacterium avium complex, mycobacterium avium, avium complex, mycobacterium, avium, complex
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2/7. mycobacterium avium complex pleuritis.

    Non-tuberculous mycobacterium infection is rarely accompanied by pleural involvement. We report a very rare case of Mycobacterium avium-intracellurare complex (MAC) pleuritis with massive pleural effusion. The patient was a non-compromised 67-year-old female and had been treated for pulmonary non-tuberculous mycobacterium infection. She was admitted to hospital because of general malaise, low-grade fever and right pleural effusion. Cytological examination of the effusion did not show malignant cells. MAC was only identified by culture and PCR. No other bacteria were detected. Complete resolution of the pleural effusion occurred after administration of anti-tubercular agents (isoniazid, rifampin, ethambutol) and clarithromycin.
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ranking = 0.19396870515694
keywords = avium complex, mycobacterium, avium, complex
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3/7. Lipoprotein analysis in a chyliform pleural effusion: implications for pathogenesis and diagnosis.

    A chyliform effusion is an uncommon high lipid pleural effusion that does not result from a leakage of the thoracic duct. Characteristically, it emerges from chronic pleurisy and contains high levels of cholesterol. The origin of this cholesterol is unknown, but it is often attributed to the degeneration of red and white blood cells. In this study we have carried out detailed lipoprotein analyses in a chyliform effusion, a chronic tuberculous effusion and three inflammatory effusions of recent onset, in an attempt to elucidate the process of cholesterol accumulation and possible lipoprotein alterations. Mean cholesterol was 92 mg/dl in the inflammatory exudates and 1,237 mg/dl in the chyliform effusion. In inflammatory effusions of recent onset most cholesterol was bound to low density lipoprotein (LDL) with corresponding apoprotein B levels. The chronic tuberculous exudate showed a shift of cholesterol binding towards high density lipoprotein (HDL). In the chyliform effusion most cholesterol was found in the HDL region. Our results suggest that in acute inflammation, the pleural barrier opens to plasma LDL. We hypothesize that in chronicity this cholesterol becomes trapped in the pleural space and undergoes a change in lipoprotein binding characteristics. In a chyliform effusion, cholesterol further accumulates and builds complexes containing triglycerides and proteins. In clinical routine, total cholesterol values above 200 mg/dl strongly suggest a chyliform effusion. Since triglyceride values may be as high as in chylous effusions (greater than 110 mg/dl), the diagnostic routine in all suspected high lipid effusions should involve cholesterol and triglyceride measurements.
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ranking = 2.0694868524744E-5
keywords = complex
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4/7. hepatitis b virus: a possible cause of serositis in hemodialysis patients.

    An epidemiologic survey in a maintenance hemodialysis population of 300 patients was undertaken to relate the appearance of acute serositis (pericarditis, pleuritis or ascites) to HBsAg antigenemia. A significant number of incidents of serositis occurred in patients acutely or chronically infected with hepatitis B surface antigen (HBsAg) suggesting an etiologic role for the virus in the serositis of uremia. In 2 patients with both end-stage renal disease and chronic HBsAg antigenemia, immunofluorescent studies of serosal tissues showed fluorescent clusters interpreted to be HBs antigen-antibody complexes. It is concluded that an immunologic response to viremia may be one of the causes of serositis in uremia.
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ranking = 2.0694868524744E-5
keywords = complex
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5/7. Mycobacterium avium-intracellulare pleuritis with massive pleural effusion.

    Atypical mycobacterial infection is seldom accompanied by pleural involvement. We report a very rare case of Mycobacterium avium-intracellulare pleuritis with massive pleural effusion. The patient was a non-immunocompromised 35-year-old Japanese male with insidious onset of fever, chest pain and anorexia. The pleural effusion gradually resolved with empirical antimycobacterial treatment, leaving considerable pleural adhesion and thickening.
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ranking = 0.011761521931842
keywords = avium
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6/7. Pleuroperimyocarditis caused by immunization with anticatarrh vaccine. A case report.

    A case of pleuroperimyocarditis caused by immunization with anticatarrh vaccine is described. During the most acute phase, circulating immune complexes were demonstrated in the patient's serum. The possibility that these complexes represent a pathogenic mechanism in the illness and the value of anticatarrh vaccination are discussed.
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ranking = 4.1389737049489E-5
keywords = complex
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7/7. pleurisy in primary sjogren's syndrome: T cell receptor beta-chain variable region gene bias and local autoantibody production in the pleural effusion.

    pleurisy with or without effusion has not been considered to be associated with primary sjogren's syndrome (SS), but rather to represent a manifestation of the underlying disorder, usually rheumatoid arthritis in secondary SS. We describe a patient with primary SS who presented with pleural effusions (PE) as an initial manifestation. Serological studies of paired serum and PE specimens demonstrated the occurrence of local immune reactions in the pleura, including the production of rheumatoid factor and anti-SS-A antibody, the formation of immune complexes, and activation of complement. In addition, the analysis of T cell receptor beta-chain variable (V beta) regions in the PE revealed the overexpression of a number of V beta gene products, including V beta 2 and V beta 13 that have previously been shown to be over-represented in the salivary glands of patients with SS. Thus, our report not only calls for an awareness of pleurisy as an extraglandular manifestation of primary SS, but suggests that a common biased T cell response might play a critical role in the pathogenesis of the glandular as well as extraglandular manifestations.
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ranking = 2.0694868524744E-5
keywords = complex
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