Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 18-year-old woman presented with coughing, fever, progressive dyspnea, and diffuse infiltrates on the chest X-ray film. Analysis of bronchoalveolar lavage fluid showed 73% eosinophils. Acute eosinophilic pneumonia was diagnosed. Methylprenisolone, 1 g per day was given for three days and her condition improved dramatically. No relapse was observed. Analysis of bronchoalveolar lavage fluid also showed lymphocytosis, abnormally high concentrations of ECP, GM-CSF, IL-5 and sICAM-1, and hypersegmentation of eosinophil nuclei. After steroid treatment almost all these findings returned to normal; only lymphocytosis remained. Precipitating antibodies against four kinds of fungi, including Trichoderma viridae, were noted in the serum, but the environmental provocation test was negative and those fungi were not detected in the environmental culture growth. Comparison of bronchoalveolar lavage findings obtained before and after steroid treatment can provide information on the mechanism of eosinophil accumulation in the lung. This case also draws attention to the relationship between acute and chronic eosinophilic pneumonia.
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PMID:[A case of acute eosinophilic pneumonia: bronchoalveolar lavage findings before and after steroid treatment]. 756

Hypersensitivity pneumonitis or extrinsic allergic alveolitis is an immunologically mediated lung disease caused by repeated inhalations of organic antigens. The basic histological lesion consists of a diffuse mononuclear cell infiltration of alveolar wall, alveoli, terminal bronchioles, and neighboring interstitium. The inflammation is often followed by granulomas, which then may progress to fibrosis. Unlike other infectious and noninfectious granulomatous disorders, hypersensitivity pneumonitis is limited to the lung. The disease occurs more frequently in men than in women and children. The acute form of hypersensitivity pneumonitis, characterized by fever, chills, myalgias, cough, and dyspnea, may be confused with acute pneumonitis. Although there is no single radiological, physiological, or immunologic test specific for hypersensitivity pneumonitis, the diagnosis can often be suspected on the basis of a compatible temporal relationship between pulmonary symptoms and a history of environmental or occupational exposure. Once the diagnosis is suspected, the presence of serum precipitating antibodies (immunoglobulin [lg] G), suppressor cytotoxic lymphocytosis in bronchoalveolar lavage (BAL) fluid, and granulomatous alveolitis in lung biopsy specimens is extremely helpful in confirming the diagnosis. For patients in whom the diagnosis is confirmed, avoidance of the causative antigen is the best therapy, although corticosteroids are used to suppress inflammation. Once the fibrosis has developed, the patient may gradually develop respiratory failure or cor pulmonale, possibly resulting in death.
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PMID:Hypersensitivity pneumonitis: a noninfectious granulomatosis. 756 4

A 64-year-old man was admitted complaining of cough, hemoptysis, dyspnea, and fever. His chest X-ray film on admission showed reticulo-granular shadows in both lung fields. Ausculation of his chest revealed fine crackles in both lower zones. After admission, he was treated with antibiotics, but his chest-radiographic appearance worsened temporarily, and sputum cytology results were repeatedly positive. Diagnosis was difficult. Differential cell count of the bronchoalveolar lavage fluid showed lymphocytosis, with a high CD 4/8 ratio. Transbronchial lung biopsy specimens revealed Masson bodies and alveolitis. With antibiotic therapy alone, his condition improved, and he was discharged. Five and a half hours later, his symptoms worsened and he was readmitted. His chest X-ray film on the second admission was almost the same as that on the first admission. His symptoms became less severe, and his condition improved without treatment. Hypersensitivity pneumonitis was diagnosed. Because the onset was in February, this was not considered to be a case of so-called summer type hypersensitivity pneumonitis a provocation test was done with water from the humidifier he had been using at home. The white blood cell count increased and PaO2 decreased significantly, so the result of the provocation test was thought to be positive. Therefore, so-called humidifier lung was strongly suspected. The results of sputum cytology on the first admission were probably falsely positive.
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PMID:[A case of hypersensitivity pneumonitis probably caused by a humidifier in winter]. 773 Nov 29

In conjunction with a pertussis vaccine efficacy trial in Germany, nasopharyngeal specimens were collected from May, 1992, to March, 1993, from patients with cough illnesses. Clinical data were obtained by initial and follow-up questionnaires. Bordetella parapertussis was isolated from 38 patients (mean age, 3.5 years; 68% girls). Clinical characteristics in these cases were compared with those of 76 patients (matched by age and sex) with illness caused by Bordetella pertussis during the same period. Findings were: (B. pertussis/B. parapertussis): cough > 4 weeks 57%/37% (P = 0.06); whoop 80%/59% (P = 0.07); whoop > 2 weeks 26%/18% (P = 0.05); paroxysms 90%/83% (P = 0.5); body temperature > or = 38 degrees C 9%/0% (P = 0.17); vomiting 47%/42% (P = 0.69); and mean leukocyte and lymphocyte counts 12,500/mm3 and 7600/mm3 (P < 0.0001) and 7800/mm3 and 3500/mm3 (P < 0.0001), respectively. Illness caused by B. parapertussis was typical of pertussis but less severe than that caused by B. pertussis. In contrast with B. pertussis infection, lymphocytosis is not a characteristic of B. parapertussis infection. This is most likely a result of the lack of production of lymphocytosis-promoting factor toxin by B. parapertussis.
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PMID:Clinical characteristics of illness caused by Bordetella parapertussis compared with illness caused by Bordetella pertussis. 803 48

Some patients of dermatomyositis (DM) with interstitial pneumonia (IP) have common clinical features. Clinical features of these patients are acute onset, very poor prognosis and that patients have fever, arthritis, typical skin rash, mild myositis and show low ratio of CPK/LDH, low incidence of antinuclear antibody (ANA) appearance, low inflammatory signs. We experienced two cases of this category of DM with IP and examined immunological aspects. Case 1. A 52-year-old woman was admitted in June 1, 1990 with a one-month history of arthralgia and a ten-days history of fever, skin rash, myalgia and dyspnea on exertion. On examination she had Gottron's papules on her fingers, erythema on back, bilateral elbows and legs, proximal muscle weakness and arthritis. Fine crackles were audible in the lower lung fields. Laboratory data included CPK 200 IU/l, ALD 3.2 IU/l, LDH 805 IU/l. Analysis of bronchoalveolar lavage fluid (BALF) revealed increased cellularity with lymphocytosis. She was treated with oral corticosteroid (CS), pulse CS, cyclosporin A. Inspite of these therapies, she died of progressive respiratory insufficiency in July 10, 1990. Case 2. A 23-year-old woman was admitted in April 1, 1991, with a two-month history of arthralgia and a one-month history of fever, skin rash, stomatitis, alopecia. On examination she had Gottron's papules on her fingers, erythema on malar, bilateral elbows and legs, arthritis and stomatitis. Laboratory data included CPK 97 IU/l, ALD 8.5 IU/l, LDH 779 IU/l. She began experiencing dry cough and dyspnea on exertion in May 1991. Analysis of BALF revealed increased cellularity with lymphocytosis. She was treated with oral corticosteroid(CS), pulse CS, pulse cyclophosphamide.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Two cases of acute progressive interstitial pneumonia associated with dermatomyositis--clinical features and immunological disorders]. 823 10

In this paper three outbreaks of equine influenza in Berlin (Germany) in the years of 1988, 1989 and 1991 are discussed, reporting mainly clinical, hematological, virological and some epizootiological aspects. We have detected variations from the traditional pattern of equine influenza, whereby the main clinical symptoms like cough or fever were absent in several cases. If cough was found, it was moist. Furthermore a mucous nasal discharge was present in a number of cases for a period of 4-5 days. Extreme neutropenia, lymphocytosis and predominantly an unchanged level of monocytes were observed. Several horses became ill, in spite of having been regularly vaccinated against equine influenza. As cause, a high antigenic drift of the influenza virus isolated from 1989 and 1991 is assumed in comparison to the strains that are used for the influenza vaccines available. The origin of the viruses which had caused the influenza outbreaks described could not be elucidated.
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PMID:[Equine influenza outbreaks with viral antigenic drift in Berlin 1988-1991]. 838 74

No diagnostic test for pertussis in routine use in the United States has both high sensitivity and high specificity. During a statewide increase in the incidence of pertussis in Missouri, we studied the clinical features of 153 patients with suspected pertussis in the Greater St. Louis area from whom a specimen for pertussis culture had been taken between 15 May and 19 September 1989. In this cross-sectional study, nasopharyngeal cultures were more likely to be positive for persons whose specimens were collected < 21 days after cough onset (adjusted rate ratio [RRa] and 95% confidence interval = 3.4; 1.5-8.0) and who were not receiving erythromycin/sulfamethoxazole prior to the culture [RRa = 5.8; 0.8-40.6], who had received fewer than three prior doses of pertussis vaccine [RRa = 1.8; 0.8-4.2], and whose specimen was in transit to the laboratory for < 4 days [RRa = 2.0; 0.8-5.5]. Among children < 5 years of age, spasmodic cough plus a lymphocytosis of > 10,000/mm3 was the acute symptom complex associated with the highest predictive value for a positive culture result (67%). Cough for > or = 14 days plus whoop was sensitive (81%) and specific (58%) for identifying children with culture-confirmed pertussis. Direct fluorescent antibody staining performed well as a screening test for pertussis but requires substantial commitment of personnel and resources. In the absence of a positive culture result, clinical case definitions should be used for decision making (e.g., initiation of antimicrobial therapy and routine case reporting).
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PMID:Pertussis in Missouri: evaluation of nasopharyngeal culture, direct fluorescent antibody testing, and clinical case definitions in the diagnosis of pertussis. 844 7

In a large pertussis vaccine efficacy trial in Germany, vaccinees and/or their family members were seen if a cough illness of >14 days was reported. Evidence of recent Bordetella pertussis infection included a positive culture and/or polymerase chain reaction (PCR) and/or significant antibody values in agglutination and/or ELISA assay. From July 1991 through February 1994, 246 adults were evaluated and 64 had evidence of B. pertussis infection; of these, 38% had whooping, 26% had a history of previous pertussis, and 48% were the primary cases in a family. The 64 adult cases suggest an adult attack rate in this population of 133 per 100,000 population per year. Since pertussis has been endemic and epidemic in Germany during the last 2 decades, it would seem likely that few persons would escape B. pertussis infections during childhood. In this regard, none of the serological controls lacked antibody to all four B. pertussis antigens (lymphocytosis-promoting factor, filamentous hemagglutinin, pertactin, and fimbriae-2). Thus, serological evidence of past infection may not indicate protection, and the widely held belief that individuals who have had infections with B. pertussis have lifelong clinical immunity to this disease is probably wrong.
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PMID:Pertussis in German adults. 864 31

We report four cases of acute pneumonitis due either to interferon, or a herbal drug, "Sho-saiko-to", or both in combination, in patients with chronic active hepatitis, focusing on its pathogenesis and response to prednisolone therapy. These cases shared common clinical features: fever, dry cough, dyspnoea, hypoxaemia, diffuse infiltrates both on chest radiography and chest computed tomography, restrictive pulmonary functional impairment, and alveolitis on examination of transbronchial lung biopsy, all of which suggest acute interstitial pneumonia. Furthermore, lymphocytosis was observed in association with the dominant CD8+ T-cell subset in bronchoalveolar lavage fluid. A lymphocyte stimulation test using peripheral blood was positive to interferon in one case and to Sho-saiko-to in another. All patients responded to oral prednisolone therapy. Peripheral soluble interleukin-2 receptor levels decreased in parallel with improvement in the clinical course. All patients were free of symptoms with a follow-up of 1-3 yrs. We conclude that interferon- and/or Sho-saiko-to-induced acute pneumonitis may be due to allergic-immunological mechanisms rather than toxicity, and that peripheral levels of soluble interleukin-2 receptor appear to be good markers of disease activity.
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PMID:Pneumonitis during interferon and/or herbal drug therapy in patients with chronic active hepatitis. 898 Sep 88

Only one case report concerning allergic alveolitis caused by polyester powder paint has been published previously. The aim of this study was to determine whether phthalic anhydride (PA) or trimellitic anhydride (TMA) is the alveolitis-causing agent in such paint. A 61 year old woman showed recurrent symptoms of chills, cough, and fever whilst at work. She was working in a plant where epoxy polyester powder paints were used to paint metal. The paint was found to contain low (<1%) amounts of TMA and PA. The patient showed shadowing on chest radiographs. In bronchoalveolar lavage, lymphocytosis (67%) and a low T-helper/T-suppressor ratio (0.2) were found. Transfer factor was within normal limits, but a slight reduction was verified after re-exposure to the paint. The symptoms, exposure, reduction in transfer factor, findings on chest radiographs and bronchoalveolar lavage were consistent with allergic alveolitis. In conclusion, the polyester powder paint used in the plant caused allergic alve olitis in this patient. Of the constituents in the paint, trimellitic anhydride and phthalic anhydride were the possible causative agents.
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PMID:Allergic alveolitis following exposure to epoxy polyester powder paint containing low amounts (<1%) of acid anhydrides. 915 Mar 39


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