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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten of 70 children (14%) with acute lymphoblastic leukemia developed severe interstitial pneumonitis within three weeks after induction of central nervous system prophylactic therapy. The clinical picture was characterized by fever, cough, progressive dyspnea, and hypoxemia with complete resolution in one to three weeks, except in one patient who died during the acute illness from respiratory failure. P. carinii organisms were found in the lung tissue of only one patient. The etiology of the pneumonitis in the other nine children was probably viral, acquired or activated during a period of lymphopenia and immunosuppression. The morbidity and potential mortality from the pneumonitis warrants early recognition by open lung biopsy and intensive supportive therapy.
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PMID:Acute respiratory illness in children with acute lymphoblastic leukemia. 30 Jul 96

A 22-year-old man with T cell type acute lymphoblastic leukemia in first remission underwent autologous bone marrow transplantation (BMT). The preparative regimen included cytosine arabinoside, cyclophosphamide and fractionated total body irradiation. His harvested bone marrow cells were purged with 4-hydroperoxycyclophosphamide. His serological test was positive for cytomegalovirus (CMV) before the BMT. On day 53 after the BMT, he developed dry cough and his chest X-ray film showed bilateral basilar infiltration. Bronchoalveolar lavage was performed and cytology of the specimen revealed typical cytomegaloviral inclusion bodies. DNA analysis and viral culture of the specimen were also positive for CMV. The patient was started on ganciclovir and immunoglobulin with high dose methylprednisolone. His respiratory status deteriorated, however, and the patient expired because of respiratory failure. Autopsy revealed severe interstitial pneumonitis with suppression of CMV replication from the treatment. Interstitial pneumonitis due to CMV should be considered as a significant complication of autologous BMT.
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PMID:[Cytomegaloviral interstitial pneumonia after autologous bone marrow transplantation in a case of acute lymphoblastic leukemia. Bone Marrow Transplantation Team]. 131 80

Malignant thymomas are extremely rare in children, with only 27 cases reported thus far in the pediatric surgical literature. We report four additional cases diagnosed at this institution over the past 20 years (ages 3 to 14 years). Clinical presentations included superior vena cava syndrome, cough, dyspnea, cyanosis, enlarging mediastinal mass, spontaneous pneumothorax, and pleuropericardial effusion. Three patients underwent incomplete resection of the mass or biopsy because of "unresectability" and were treated with radiotherapy and adjunctive chemotherapy. One patient underwent near complete macroscopic resection as well as radiotherapy and chemotherapy. All patients died at intervals ranging from 6 months to 2 1/2 years after diagnosis. Three patients were found to have metastatic disease prior to death or at autopsy. In one case, the initial pathological diagnosis was lymphocytic thymoma. After ultrastructural studies were performed, the diagnosis was changed to thymic T-cell lymphoma. This patient subsequently developed acute lymphoblastic leukemia 3 months after surgical resection followed by radiotherapy. Malignant thymomas are highly aggressive tumors in children. A radical surgical approach with complete excision of the tumor and contiguous structures in continuity, with adjunctive radiotherapy and chemotherapy remains the only hope for survival in children with these rare lesions.
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PMID:Malignant thymoma in children: a 20-year review. 227 28

Pulmonary fungal infections complicating hematological malignancies are difficult to diagnose antemortem because clinical findings are actually considered to be not specific. From December 1984 to June 1986 we documented the clinical findings in sixteen patients, 9 with ANLL, 6 with ALL and 1 with CML + BC; all patients were diagnosed as pulmonary fungal infection and treated for this complication. Pulmonary infiltrates occurred after severe aplasia (range 5-90 days) or during bone marrow relapse. We studied pulmonary signs and symptoms (pleuritic pain, cough, hemoptysis, shortness of breath, rales, rub, bronchial murmur) both at the beginning and during the management of this infectious complication and we related them to chest x-ray findings, the duration of granulocytopenia, and fever. Our purpose was to identify clinical characteristics for these episodes and establish roentgenological criteria for prognosis. These findings should improve the possibilities for an early diagnosis and prompt treatment.
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PMID:[Pulmonary mycosis as a complication of acute leukemia in the adult. Diagnostic study]. 274 May 98

We report a case of hypereosinophilic syndrome associated with acute lymphoblastic leukemia (L1 type, FAB classification) which showed an abnormal karyotype. An 8-year-old boy was admitted to our hospital with complaints of fever and cough that had persisted for 2 weeks. Peripheral blood examination revealed remarkable eosinophilia (120,000/mm3) and a few lymphoblasts. Bone marrow examination also revealed many mature eosinophils and 20% lymphoblasts that were PAS and peroxidase negative. A direct chromosome analysis of the bone marrow cells demonstrated that 12.5% of the spontaneously dividing cells had an abnormal karyotype of 46XY, t(5;14) (q31;q32). The chest radiogram showed interstitial pneumonia-like densities, and the ECG had the pattern of a right bundle branch block. The therapy consisted of prednisolone, high dose of methylprednisolone, cyclophosphamide, and vincristine. This treatment failed to reduce the eosinophil count. On the 4th day after admission, the patient developed severe dyspnea, complete A-V block, and died. At postmortem, dense infiltrations of eosinophils in various stages of maturation were noted in lungs and liver.
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PMID:Hypereosinophilic syndrome in acute lymphoblastic leukemia with a chromosome translocation [t(5q;14q)]. 658 69

Three cases of presumed respiratory syncytial virus (RSV) pneumonia in immunocompromised adults are described. Two patients had symptoms of cough, fever, and malaise, following completion of a course of combination chemotherapy for the treatment of acute lymphoblastic leukemia. The third patient, a juvenile onset diabetic, developed similar symptoms while hospitalized for severe hyperglycemia. Chest roentgenograms showed lower lobe infiltrates in both leukemic patients and a bilateral non-confluent bronchopneumonia in the diabetic patient. All patients had a marked rise in complement-fixing antibody titres to RSV, suggesting a concurrent infection with the virus. Extensive microbiological investigations failed to reveal any other etiologic agent. Nosocomial infection was considered possible. RSV is not considered a cause of pneumonia in compromised adults. Our three cases suggest that there may be a higher incidence of RSV pneumonia in compromised patients, than previously recognized.
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PMID:Presumed respiratory syncytial virus pneumonia in three immunocompromised adults. 684 93

A patient suffering from acute lymphoblastic leukemia, in complete remission for two years, is treated for haematologic relapse with V.P.D. and C.O.A.P. consolidation. After this treatment, develops tiredness, sleepiness, a slight fever and cough, dying some days after, of interstitial pneumonia. Post-mortem anatomic-pathological studies, show giant cell multinucleated pneumopathia, with intranuclear inclusions bodies, that in ultrastructural level resembles paramyxovirus. When this complication took place, the patient had a brother with measles, but he hasn't, the typical symptomatology of said virus disease. According to Siegel, authors point out the frequency of death due to interstitial pneumonia as a complication caused by measles in immunodeficient patients, remarking the importance of an immediate diagnosis and its' prophylaxis.
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PMID:[Giant cell pneumonia. Complication in one case of acute lymphoblastic leukemia (author's transl)]. 693 58

A 22-year-old man in his first relapse of T-acute lymphoblastic leukemia developed fever and a pulmonary infiltrate after 23 days of granulocytopenia. Although having been under amphotericin B for 10 days, productive purulent cough ensued, with right lobe atelectasis and acute ventilatory failure that resolved after the elimination of a thick gelatinous bronchial plug. Sputum cultures yielded Candida Albicans and Staphylococcus epidermidis, and microscopic examination of the sputum plug disclosed Aspergillus hyphae. The patient died 9 days after, of a disseminated Aspergillus infection, confirmed by necropsy.
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PMID:Aspergillary bronchopneumonia: an unusual cause of atelectasis and asphyxia in a leukemic patient. 748 28

A 51-year-old female was who admitted complaining of cough and slight fever and lower limb petechia. The laboratory examinations revealed leukocytosis (49,400/microliters) with blasts (71%) in the peripheral blood. The NCC was 30 x 10(4)/microliters with 84.8% blasts in the bone marrow. Myeloperoxidase staining was positive for 6% of blasts. Auer rods were not seen in some blasts. Thus, acute myeloblastic leukemia (M1) was diagnosed according to FAB classification. In the peripheral blood, 43.3% of blasts expressed CD19, 10.3% of blasts expressed CD20 and 55.6% of blasts expressed CD33 on admission. Though she received two courses of DCMP according to the DCMP-85 protocol, and one combined course of mitoxantrone, etoposide, and Ara-C. The NCC was 20.0 x 10(4)/microliters with 70% blasts in the bone marrow. CD19 was expressed by 72.4% of blasts and 35.0% expressed CD20. The ALL-90 protocol was started, but remission was not achieved. Thus this case was considered to be acute mixed lineage leukemia.
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PMID:[Acute mixed lineage leukemia showing resistance to AML and ALL therapy]. 768 36

This 35-year-old housewife was initially treated with vincristine, prednisolone and L-asparaginase for acute lymphoblastic leukemia (ALL, L1 by FAB classification) in 1988 and entered into complete remission. Ten months later she underwent bone marrow transplantation (BMT) from her HLA-identical and MLC-negative sister. The conditioning regimens consisted of busulfan 4 mg/kg/day for 4 days orally and cyclophosphamide 60 mg/kg/day for 2 days intravenously followed by cyclosporine and prednisolone for graft-versus-host disease prophylaxis. Fifty days after BMT, she suffered interstitial pneumonitis and a gastric ulcer, and was treated with a high dose of methylprednisolone and cimetidine. She experienced transient improvement, but soon cough, dyspnea and epigastralgia became worse. The specimens obtained by transbronchial alveolar lavage (BAL) and endoscopic gastric biopsy showed many giant cells containing inclusion bodies which were identified as cytomegalovirus (CMV). This time ganciclovir was started in addition to prednisolone. Then she gradually improved and after repeated BAL and the gastric biopsy after treatment showed no inclusion body in the specimen. Although leukocytopenia was significant for this patient, ganciclovir is considered to be useful for controlling CMV infection in both the lungs and stomach.
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PMID:[Good response to ganciclovir in a patient of cytomegalovirus (CMV) interstitial pneumonitis and gastric ulcer following allogeneic bone marrow transplantation for acute lymphoblastic leukemia]. 774 99


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