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Target Concepts:
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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)
Diffuse alveolar hemorrhage (DAH) can be a serious and life threating condition. Illicit substance use has been associated with DAH, with cocaine being the most widely reported. Marijuana use has been associated with pulmonary complications in the form of pneumomediatsium, pneumothorax, bullous disease, and pulmonary aspergillosis. We present a case of diffuse alveolar hemorrhage (DAH) resulting from marijuana inhalation, a finding rarely described in the literature.
A 21
-year-old male presented with several episodes of hemoptysis after drinking alcohol and smoking marijuana. He reported smoking 5-8 joints per day of marijuana (he denied use of bongs or other inhalant aids). His respiratory exam revealed bilateral fine rales. Laboratory evaluation included leukocytosis with left shift, normal platelets, coagulation profile, and a urine toxicology screen positive for tetrahydocanabinoid (THC). Chest CT revealed bilateral diffuse alveolar infiltrates suggestive of DAH. A bronchoscopy with
BAL
of bilateral upper lobes consistent with DAH with negative microbiologic studies, hemosiderin laden macrophages were present. Additional workup included a normal Echocardiogram, negative autoimmune serologies. His hemoptysis resolved with supportive care. DAH is a potentially fatal disease that has been associated with illicit substance use, most commonly cocaine. Recently, reports have surfaced associating marijuana use with DAH, though these cases have all involved the use of bongs or other inhalant aids, leading to the hypothesis that combustibles and inhaled particles may be the etiologic factor. This is the second report of DAH developing after smoking only marijuana, though the etiology for the association between marijuana use and DAH remains uncertain.
...
PMID:Up in smoke: An unusual case of diffuse alveolar hemorrhage from marijuana. 2999 53
We studied cytokine profiles in
BAL
of LTRs with Aspergillus spp colonization who did not progress to
IPA
in the absence of antifungal prophylaxis. This was a retrospective, single center case-control study.
BAL
samples were analyzed for cytokines. Patients with Aspergillus spp in
BAL
who did not receive prophylaxis and did not develop
IPA
were compared to LTRs with Aspergillus spp that received prophylaxis, LTRs with
IPA
and controls. Twenty-one patients with Aspergillus colonization who did not develop
IPA
, seven patients with suspected
IPA
who received prophylaxis, 4
IPA
and 19 controls were included.
IPA
group had significantly higher levels (median [IQR]) of MIP-1 beta compared to the Suspected
IPA
group (5 vs 5 P: 0.03). The Suspected
IPA
group had significantly higher levels of IL-12 (11.38 vs 1 P: 0.0001), IL-1 RA (86.11 vs 23.98 P: 0.0118), IP-10 (22.47 vs 0.86 P: 0.0151), HGF (40.92 vs 16.82 P: 0.0055), and MIG (169.62 vs 5 P: 0.0005) than Colonization group. We have identified a unique cytokine signature in patients with Aspergillus colonization that do not develop
IPA
. Our study forms basis for a larger study to use these cytokines profile to identify patients at a lower risk of developing
IPA
.
...
PMID:Cytokine profile in lung transplant recipients with Aspergillus spp colonization. 3075 47