Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:6.2.1.7 (BAL)
 1,977 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The objective of this study was to evaluate the mechanisms of colchicine action in pulmonary fibrosis. The study included 10 patients with pulmonary fibrosis (idiopathic pulmonary fibrosis 5, asbestosis 4, and scleroderma 1) who had been admitted to Bellevue Hospital Center, a tertiary care public hospital in New York City. We administered colchicine 0.6 mg orally for 12 weeks to patients with pulmonary fibrosis. Symptoms, high resolution CT scans, pulmonary function tests, and bronchoalveolar lavage parameters were compared prior to and after treatment. Results showed declines in dyspnea index, selective improvement in several CT scans, but no statistically significant change in BAL cells, cytokines, fibronectin, or hydroxyproline. However, there was a decline in hydroxyproline in the BAL fluid in 8/10 patients. We concluded that colchicine has a mild antifibrotic effect which may be in inhibiting collagen formation since there was no effect on the inflammation that accompanies fibrosis.
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PMID:Mechanisms of colchicine effect in the treatment of asbestosis and idiopathic pulmonary fibrosis. 1217 1

Pulmonary alveolar microlithiasis is characterized by the presence in pulmonary alveolus of round shaped little bodies containing concentric calcareous lamellas. The incidence is similar in all continents, in both sexes and it is higher in age brackets between 20 and 50 years. The disease is prevalent among family units. Clinical reports may suggest the hypothesis that the disease may be hereditary. Pathogenetic hypotheses may indicate that a reduced lung mucociliary function leading to an excess of alveolar mucus may induce the formation of alveolar microliths by mucus condensation. Microliths may appear either confined in particular areas of the lung or widespread. Chemically, microliths consist of large amounts of calcium and phosphorus and, in reference to histology, they consist of calcareous concentric lamellas which are placed around an amorphous or granular central nucleus. The dissociation between definite X-ray pattern of lungs and relative poor clinical symptoms is the most common characteristics of the disease. However, a certain degree of dyspnea with a productive cough may occur together with a sporadic hemoptysis and thoracic pains. X-ray pattern of the lung reveals dissemination of radio-opaque nodules which may make lungs appear to be sprinkled with sand. The evolutive course of the disease leads to pulmonary insufficiency which is related to the increase of number of microliths in several areas of lungs. The inability to identify clear etiological and pathogenetic elements makes difficult therapeutic approach which is palliative such as the use of diphosphonate, steroids and therapeutic BAL.
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PMID:Pulmonary alveolar microlithiasis: an overview of clinical and pathological features together with possible therapies. 1456 Oct 14

This case, in a 23-year-old man presenting with cough, sputum, dyspnea on effort and wheezing, had been diagnosed as bronchial asthma at another hospital. Because inhaled steroid and theophylline were far from effective, he was admitted to our hospital for further evaluation. A blood test revealed marked eosinophilia. Chest radiography showed diffuse, small nodular shadows in both lung fields, and a chest CT scan demonstrated diffuse centrilobular nodules and thickening of the bronchi and bronchioles. A spirometric test showed obstructive and restrictive ventilatory impairment, but the depressed forced vital capacity failed to show improvement in response to bronchodilator inhalation, discouraging a diagnosis of asthma. Eosinophilic lung disease with prominent eosinophilic bronchiolitis was diagnosed on the basis of BAL eosinophilia and thoracoscopic lung biopsy findings. The symptoms and blood eosinophilia were responsive to administration of oral prednisolone (30 mg daily); radiographic and CT findings also showed improvement. This case showed a marked similarity to the recently reported "eosinophilic bronchiolitis", and was probably not a type of bronchial asthma.
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PMID:[A case of eosinophilic lung disease presenting asthma-like symptoms and centrilobular shadows in both lung fields]. 1458 93

A 59-year-old woman was admitted to hospital 10 months after receiving a liver transplant (LT) for hepatitis C virus (HCV) cirrhosis because of fever, dyspnea and basal patchy peripheral infiltrates. Microscopic examinations and blood, sputum and BAL cultures were negative. Empirical anti-infective therapy was ineffective. Thoracoscopic lung biopsy was performed, and histology showed a pattern suggesting bronchiolitis obliterans organizing pneumonia (BOOP). Prednisone led to rapid clinical and radiologic improvement. BOOP has been anecdotally reported in LT cases, and this case was unrelated to any infectious agent. BOOP should be taken into account in the differential diagnosis of pneumonia in LT.
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PMID:A 59-year-old liver-transplanted woman with fever, dyspnea and pulmonary infiltrates. 1461 53

We describe the first known Japanese patient with chronic eosinophilic pneumonia caused by Schizophyllum commune. The patient presented to Social Insurance Tagawa Hospital, Fukuoka, Japan with cough, wheezing, dyspnoea, and fever. Computed tomograms of the chest showed bilateral areas of consolidation with air bronchograms as well as interstitial infiltrates in the upper lobe, without ectasia of proximal bronchi. Fibreoptic bronchoscopy revealed no impacted mucus in the bronchi. BAL fluid from the right upper lobe yielded an increased total cell count with a high percentage of eosinophils. A transbronchial lung biopsy specimen showed a bronchoalveolar chronic inflammatory infiltrate composed of eosinophils, lymphocytes and plasma cells, associated with fibrosis of the alveolar walls. S. commune was identified in lavage fluid. Antibodies to this organism were present in the serum, confirming that S. commune was the cause of chronic eosinophilic pneumonia. Inhaled corticosteroids without accompanying oral corticosteroids or antifungal agents decreased the respiratory symptoms, and the infiltrates disappeared from the chest radiograph within a few days
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PMID:Chronic eosinophilic pneumonia associated with Schizophyllum commune. 1470 55

Bacterial flora of various strains was isolated from sputum and in some cases from BAL fluid of 75 patients with obstructive pulmonary disease experiencing dyspnea symptoms accompanying infections of respiratory tract. Among strains recognized traditionally as pathogenic in respiratory tract, we also isolated various strains typically called "normal oropharyngeal flora", "physiologic" or "non-pathogenic" bacteria. Those latter strains used in the skin tests in autologous manner for each patient had the property of provoking early (15 min) and late (24-48h) reactions. Early reactivity resembles that induced in the tests with airborn allergens. This suggests a potentially important role of those currently ignored strains in pathogenesis of obstructive pulmonary disease.
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PMID:Skin reactivity to autologous bacteria isolated from respiratory tract of patients with obstructive pulmonary disease. 1530 5

A 45-year-old Japanese electrical engineer was admitted to our department of internal medicine on August 12, 2003, because of a sudden high fever and severe hypoxic respiratory failure. At a barbecue with his family on August 3 beside a nearby river, he had been exposed to the smoke. From August 4 to 11, he had suffered fatigue, fever, dry cough and progressive dyspnea. On admission, his SpO2 was 84%, and computed tomography scanning showed patchy ground glass opacity, thickened bronchial walls, and bilateral pleural effusions. The eosinophil count in the bronchoalveolar lavage fluid (BALF) was increased to 52.4%. Noticeably, the KL-6, SP-A and SP-D levels in the serum were elevated to 197 U/ml, 188 ng/ml and 137 ng/ml, and their levels in BALF had also increased to 225 U/ml, 890 ng/ml and 1110 ng/ml, respectively. The lymphocyte stimulation test was negative, and the cultures of blood and BALF did not grow any pathogens. The patient had smoked 1 pack of per cigarettes day for 25 years and showed no sign of atopic illness. Acute eosinophilic pneumonia (AEP) was diagnosed, and responded dramatically to treatment with oxygen and corticosteroids. The dissociation between the normal KL-6 levels and the elevated SP-A and SP-D levels in the serum and BAL fluid may play an important role in cases of AEP.
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PMID:[A case of acute eosinophilic pneumonia with a disassociation between the KL-6 level and SP-A and SP-D levels in the serum and BAL fluid]. 1535 66

Acute ingestion of copper sulfate has been reported to cause gastrointestinal injury, hemolysis, methemoglobinemia, hepatorenal failure, shock; or even death. The toxicity of organocopper compounds, however, remains largely unknown. A 40-y-old man attempted suicide by ingesting some 50 ml of Sesamine fungicide. He immediately developed headache, vomiting and abdominal pain, followed by progressive dyspnea, cyanosis, dark urine and diarrhea. Severe methemoglobinemia and hemolysis were documented, and treatment with ascorbic acid and hydration was commenced. He was referred to our service 3 d later for methylene blue treatment. Despite the above treatment, his symptomatology persisted and it was not until 5 d post-ingestion that the implicated fungicide was identified as copper-8-hydroxyquinolate. BAL therapy and plasma exchange were instituted, which decreased his plasma hemoglobin from 1,300 mg/dL to 29.1 mg/dL, and lowered his methemoglobin level from 20.9% to 1.1%. His serum and urine copper concentration dropped from 238 microg/dL to 96 microg/dL and from 112 microg/dL to 16 microg/dL, respectively. He was discharged uneventfully 18 d post-ingestion. Pre-existing glucose-6-phosphate dehydrogenase (G6PD) deficiency as well as copper-induced inhibition of G6PD activity was documented during hospitalization. Organocopper compounds may cause prolonged hemolysis and methemoglobinemia through oxidative stress, especially among patients with G6PD deficiency. Antidotal therapy with methylene blue is not likely to be effective in this setting: treatment with intensive supportive measures and other therapeutic options, such as plasma exchange, should be sought.
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PMID:Prolonged hemolysis and methemoglobinemia following organic copper fungicide ingestion. 1558 50

Asbestosis is a diffuse interstitial pulmonary fibrosis, secondary to the inhalation of asbestos fibres. There is a dose-response relationship between exposure to asbestos and the risk of developing asbestosis, in such a way that the greater the exposure, the greater the risk of developing the disease. The time of clinical latency is inversely proportional to the level of exposure. Dyspnoea upon exertion and a dry cough together with end-inspiratory crackles are the most frequent symptoms and signs. Chest radiography is a basic tool in identifying the disease, however high resolution CAT has added greater sensitivity. Tests of the respiratory function show alterations and restrictive ventilations with a reduction of pulmonary spread. Determination of asbestos bodies in BAL is an indicator of exposure, although their absence does not rule out the disease. A histopathological diagnosis is the most reliable, although in the majority of cases the diagnosis is established on the basis of the existence of an antecedent of exposure to asbestos together with suggestive clinical, radiological and functional findings, and a suitable time of latency, without having recourse to a pulmonary biopsy.
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PMID:[Asbestosis]. 1591 70

Drug induced lung diseases (DILD) are an increasing cause of morbidity. Many drugs have been described, causing several patterns of injury. Sirolimus is an immunosuppressive agent increasingly used in renal and other solid organ transplantation. Pulmonary toxicity has been recognised as a potential complication associated to this medication. Interstitial pneumonitis and more rarely alveolar haemorrhage have been described. The authors describe 4 cases (3 men and 1 woman) between 46-71 years, transplanted three years ago (1 patient) and 7 years ago (3 patients). All of them were medicated with micofenolato mofetil, prednisone and sirolimus. All patients had fever at admission, 3 patients had dyspnoea and 2 productive cough. Diffuse pulmonary infiltrates with basal predominance in HRCT scan were present in the four patients. BAL showed lymphocytic alveolitis in 3 cases, however with a different CD4/CD8 ratio. In addition to lymphocytosis, neutrophilia was observed in 2 patients. One patient showed serious alveolar haemorrhage in BAL. Pulmonary infections were ruled out by specific BAL staining and cultures. After drug suspension, all patients showed a clear improvement. These case studies show some diversity in clinical presentation and in the features of some exams, namely in BAL. This may suggest different underlying pathophysiology entities induced by sirolimus.
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PMID:[Lung toxicity induced by rapamycin]. 1730 25


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