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

A 61-year-old man was admitted to our hospital with fever, cough and dyspnea on exertion. The chest X-ray showed diffuse reticulo-granular infiltrates. Deterioration of clinical features and remarkable elevation of BALF lymphocytes (64.3%) suggested active interstitial pneumonia. The open lung biopsy specimen showed chronic interstitial pneumonia with DIP-like pathologic change. There was a remarkable clinical, physiological and roentgenographic improvement associated with decrease of BALF lymphocytes in response to steroid therapy. BAL is useful for monitoring disease activity and tapering steroids in patients with interstitial pneumonia who respond to steroid therapy.
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PMID:[Desquamative interstitial pneumonia-like changes in idiopathic pulmonary fibrosis]. 226 32

An occupational interstitial pulmonary disease was observed in a 59-year-old workman after five years of massive exposure to aerosolized paraffin. Histologic studies of open-lung biopsy showed a lipoid pneumonia characterized by (1) alveolitis involving large lipid-laden macrophages and (2) interstitial fibrosis. Electron microscopy of AMs disclosed features of paraffin-laden cytoplasmic vacuoles. Successive treatments included prednisolone and cyclophosphamide. Despite these treatments and withdrawal from exposure, the pulmonary function became impaired progressively, resulting in restrictive syndrome and severe exertional dyspnea. Concomitantly, PMNs harvested by BAL increased, whereas initial lymphocytosis decreased. This is the first case observed of occupational interstitial fibrosis in which electron-microscopic findings clearly established a relationship with an exposure to paraffin. This observation also emphasizes the switch from alveolitis to fibrosis in the pathogenesis of interstitial pulmonary disease.
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PMID:Interstitial pulmonary disease induced by occupational exposure to paraffin. 229 45

A 61-yr-old woman was evaluated for dyspnea on exertion and interstitial lung disease. A unique association between inhaled particulates from wood burning and interstitial pneumonitis was demonstrated. Bronchoalveolar lavage revealed numerous particulates and fibers, as well as cellular and immunoglobulin abnormalities. The particles were shown to be carbonaceous by energy dispersive X-ray analysis (EDXA). Inflammation and fibrosis were found surrounding them on open biopsy. The particle source was traced to a malfunctioning wood-burning heater in the patient's home. We present this case to highlight the usefulness of BAL and EDXA in the elucidation of particle-associated lung disease.
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PMID:Interstitial lung disease and domestic wood burning. 319 18

A 60-year-old woman was admitted to our hospital because of progressive cough and chest pain for 2 months. She also complained of exertional dyspnea. Bilateral diffuse infiltlative shadows were found on the chest roentogenogram. Ground-glass opacity in the middle lobe and lingula, and subpleural patchy consolidation were seen on the computed tomogram of the chest. Arterial oxygenation and diffusing capacity were low. The level of angiotensin-converting enzyme in serum was normal, but that of lysozyme was high. In the BAL (broncho-alveolar lavage) fluid, total cell count and the number of lymphocytes were high, and the CD 4/8 ratio of the lymphocytes was high. Open lung biopsy revealed numerous confluent sarcoid granulomas with necrosis, which strongly correlated with severe vasculitis. After necrotizing sarcoid granulomatosis was diagnosed, prednisolone was administered, which resulted in improvement of symptoms and disappearance of chest-radiograph shadows. Necrotizing sarcoid granulomatosis may be seen as a variant type of sarcoidosis. However, clinical findings including the chest-radiograph shadows and clinical course of this case differ from those of ordinary sarcoidosis. These clinical findings can be attributed to severe vasculitis, as revealed by histological examination.
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PMID:[A case of necrotizing sarcoid granulomatosis]. 773 Nov 25

We describe the case of a heavy marijuana and tobacco smoker who presented with progressive exertional dyspnea of 2 months' duration, and bilateral nodular lung infiltrates. Examination of the lung fields was normal, and lung function tests showed mild airflow obstruction with moderately reduced gas transfer. BAL returned green-black fluid consisting predominantly of macrophages laden with carbon pigment. Thoracoscopic lung biopsy showed miliary necrotizing granulomata with an alveolar exudate of carbon-laden macrophages within macroscopically blackened lung. The differential diagnosis of pulmonary granulomata in this patient is discussed.
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PMID:Necrotizing pulmonary granulomata in a marijuana smoker. 1080 46

Bullous pemphigoid, the most common autoimmune blistering disease, is characterized by an autoimmune response to a component of hemidesmosomes within the dermal-epidermal junction. Immunofluorescence examination of skin biopsies demonstrates linear deposition of IgG and C3 in the basement membrane zone. A 73-year-old woman was admitted to our institution because of interstitial lung disease with persistent dry cough, dyspnea on exertion, and bullous eruptions on the skin of her trunk and extremities. Chest CT scan, BAL fluid, and transbronchial lung biopsy findings indicated a likely nonspecific interstitial pneumonia pattern. Direct immunofluorescence showed linear deposition of IgG and C3 along the basement membranes of the lung and skin specimens. Lung disorders associated with bullous pemphigoid are extremely rare, and, to our knowledge, this is the first report of an immunologically confirmed case of interstitial pneumonia.
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PMID:Interstitial pneumonia associated with bullous pemphigoid. 2239 66

We report a case of lethal interstitial pneumonia that occurred after neoadjuvant chemotherapy for advanced gastric cancer. A 76-year-old man with no history of interstitial pneumonia received 2 courses of S-1 (100 mg/body) following 1 course of S-1 plus cisplatin( CDDP) from June 2012. He complained of dyspnea on exertion 6 days after completion of the treatment. Chest radiography and computed tomography (CT) revealed diffuse interstitial lesions in bilateral lung fields. Bronchoalveolar lavage( BAL) revealed an increased number of lymphocytes and leukocytes. Transbronchial lung biopsy (TBLB) revealed interstitial pneumonia with fibrous thickening in the alveolar septum. The drug lymphocyte stimulation test (DLST) was positive for S-1 and negative for CDDP. These results suggested that S-1 had induced interstitial pneumonia. Steroid therapy( 40 mg/day prednisolone following 500 mg methylprednisolone pulse therapy) and an antibiotic agent were administered but were ineffective. He rapidly developed respiratory failure and required tracheal intubation and mechanical ventilation on hospital day 24, and died on hospital day 38.
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PMID:[A case of lethal interstitial pneumonia after neoadjuvant chemotherapy for advanced gastric cancer]. 2439 95

Bakers are exposed daily to flour and may be susceptible to immunologic occupational diseases. A 30-year-old, nonsmoking, female baker was referred for progressive dyspnea on exertion, basal crackles on auscultation, restrictive lung function, decreased diffusing capacity of the lung for carbon monoxide, ground glass hyperdensities with a mosaic pattern on high-resolution CT scan, 25% lymphocytosis by BAL, and cellular chronic bronchiolitis with peribronchiolar interstitial inflammation by lung biopsy specimen. Cultures from flours isolated nine species, including Aspergillus fumigatus. Twenty-six antigens were tested. Serum-specific precipitins were found against A fumigatus, the flour mite Acarus siro, and total extracts from maize and oat. Outcome was favorable with cessation of occupational exposure to flours and transient therapy with prednisone and immunosuppressive agents. To our knowledge, this report is the first of a well-documented case of hypersensitivity pneumonitis due to sensitization to fungi- and mite-contaminated flours. Hypersensitivity pneumonitis--and not only asthma and allergic rhinitis--should be suspected in bakers with respiratory symptoms.
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PMID:Occupational hypersensitivity pneumonitis in a baker: a new cause. 2468 6