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)

Ninety-eight patients with middle lobe syndrome were reviewed. There were 31 male and 67 female patients ranging in age from 4 to 80 years. The most common presenting symptoms were cough, dyspnea, fever, hemoptysis, and chest pain. Diagnostic studies included chest roentgenogram, bronchoscopy, and bronchography. Sixty-five patients had full recovery following intensive medical therapy. Thirty-one patients underwent surgical resection for persistent disease. There were five post-operative complications and 1 death in this series.
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PMID:Middle lobe syndrome: diagnosis and management. 706 61

From 1988 to 1995, a bronchial washing was performed on 118 cases of middle lobe syndrome at the National Himeji Hospital. Twenty cases (16.9%) were positive for Mycobacterium avium complex (MAC). All cases were middle-aged (mean age 54.8), non-smoking women. Fourteen cases were asymptomatic and showed only abnormal shadow on chest X-ray film, while others complained cough, sputum or hemosputum. CT examinations were done on 13 patients, and pulmonary infiltrations were found in addition to right middle lobe or lingula in many cases. It is important to note that MAC infection might be one of causes of middle lobe syndrome.
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PMID:[Evaluation of middle lobe syndrome: bronchial washing cultures testing positive for Mycobacterium avium complex]. 907 Oct 87

Bronchial anthracofibrosis, a clinical entity described less than a decade ago, is characterised by anthracotic pigmentation of the bronchial mucosa with multifocal bronchial lumen narrowing. The right middle lobe is predominantly involved and is frequently associated with tuberculosis. The condition is generally seen in non-smoking elderly ladies with a longstanding history of wood smoke exposure. A 65 year-old lady presented to us with a one-month history of dry cough. The chest radiograph revealed a middle lobe syndrome which was confirmed on computed tomography (CT) scanning. In addition, narrowing of the right middle lobe bronchus was seen. This raised the suspicion of a malignancy. Fibreoptic bronchoscopy revealed anthracotic pigmentation, and bronchial aspirate showed acid fast bacilli. Culture of the aspirate grew Mycobacterium tuberculosis. The patient responded to standard antituberculous treatment.
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PMID:Bronchial anthracofibrosis and tuberculosis presenting as a middle lobe syndrome. 1825 79

Endobronchial tuberculosis (EBTB) is an infection of the tracheobronchial tree. A 17-year-old male patient with tuberculosis who developed middle lobe syndrome on antituberculous treatment is presented. The patient was admitted with complaints of fever, cough and weight loss. Right paracardiac and perihilar heterogeneous infiltrations were present. During fiberoptic bronchoscopy, the right middle lobe was found to be obstructed. Tuberculosis was diagnosed based on necrotizing granulomas in the bronchial biopsy and culture growth of M tuberculosis. After antituberculous and corticosteroid treatment, progression occurred. The endobronchial lesion was removed with argon plasma coagulation. After bronchoscopy, the patient's radiologic findings and clinical condition improved. In cases progressing despite steroid treatment, alternative treatments may be beneficial.
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PMID:Endobronchial tuberculosis with lobar obstruction successfully treated by argon plasma coagulation. 1973 20

A 53-year-old woman presented with progressive cough related to an endobronchial carcinoid tumour. The location of the tumour in the right upper lobe bronchus could be described as an "upper lobe syndrome" by analogy with the "middle lobe syndrome" or Brock's syndrome. Surgical management consisted of lobectomy and lymph node dissection. This established the diagnosis of typical carcinoid tumour. There was no mediastinal nodal invasion. Three months after surgery all symptoms had disappeared.
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PMID:[A case of a carcinoid tumour presenting as an "upper lobe syndrome"]. 2212 46

The term bronchial hyperresponsiveness is generally used to describe a heightened airway smooth muscle bronchoconstrictor response measured by bronchoprovocation testing. However, the airway also responds to inflammation or bronchoprovocation with increased mucus secretion. We use the term "secretory hyperresponsiveness" to mean increased mucus secretion either intrinsically or in response to bronchoprovocation. This is not the same as retained phlegm or sputum. Unlike smooth muscle contraction, which is rapidly reversible using a bronchodilator, mucus hypersecretion produces airflow limitation that reverses more slowly and depends upon secretion clearance from the airway. Certain groups of patients appear to have greater mucus secretory response, including those with middle lobe syndrome, cough-dominant ("cough-variant") asthma, and severe asthma. Secretory hyperresponsiveness also is a component of forms of lung cancer associated with bronchorrhea. An extreme form of secretory hyperresponsiveness may lead to plastic bronchitis, a disease characterized by rigid branching mucus casts that obstruct the airway. Secretory hyperresponsiveness and mucus hypersecretion appear to be related to activation of the extracellular-regulated kinase 1/2, signaling through the epidermal growth factor receptor, or secretory phospholipases A2. Recognizing secretory hyperresponsiveness as a distinct clinical entity may lead to more effective and targeted therapy for these diseases.
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PMID:Secretory hyperresponsiveness and pulmonary mucus hypersecretion. 2509 55

Imaging is crucial to the diagnosis of pulmonary hydatid disease, as it is often the first modality that raises suspicion of the disease. Middle lobe syndrome (MLS) as a presentation of this disease is a distinct rarity. A 45-year-old woman, a never-smoker, presented with cough and streaky haemoptysis. Imaging demonstrated a trapezoidal opacity with its base towards the hilum and contiguous with the right cardiac border. The reformatted sagittal view confirmed the diagnosis of MLS. Fibreoptic bronchoscopy (FOB) revealed an avascular white membranous structure wholly occluding the medial segment of the middle lobe. This was completely removed through gentle suction. Bronchial aspirate revealed hooklets of hydatid and echinococcal serology was positive. Subsequently, three cycles of albendazole were administered with remarkable clinical and radiological improvement. To the best of our knowledge, this is the first detailed description of MLS caused by pulmonary hydatidosis that was completely removed through FOB.
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PMID:Middle lobe syndrome: a singularly rare presentation of complicated pulmonary hydatid disease. 2704 51

Pulmonary involvement in amyloidosis is a distinct rarity. This clinical entity usually presents as tracheobronchial amyloidosis (TBA). A 32-year-old, never-smoker man presented with episodic dyspnoea and wheezing along with cough and mucoid sputum. The chest radiograph was suggestive of a middle lobe syndrome (MLS). High-resolution CT (HRCT) of the chest confirmed the presence of MLS. In addition, HRCT showed circumferential thickening of the trachea and the main bronchi, with thickening of the posterior membranous wall of trachea. Fibrebronchoscopy, done to evaluate MLS, visualised multiple small polypoidal lesions in the lower part of trachea and carina. Endobronchial biopsies showed homogeneous, acellular amorphous deposit in the subepithelial region, which was congophilic in nature. A diagnosis of TBA presenting as MLS was made. To the best of our knowledge, this is the first detailed report of MLS as a presentation of TBA in the English literature.
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PMID:Middle lobe syndrome: an intriguing presentation of tracheobronchial amyloidosis. 2853 21

Lepidic adenocarcinoma previously known as bronchioloalveolar carcinoma (BAC) is a non-small cell lung cancer with an indolent presentation. Bronchial anthracofibrosis (BAF) is caused by long-standing exposure to biomass fuel smoke often in poorly ventilated kitchen. Middle lobe syndrome (MLS) due to BAF is not uncommon however, lepidic adenocarcinoma then known as BAC, presenting as MLS has been documented only once before in the Polish literature. A 68-year-old never-smoker female with biomass fuel smoke exposure presented with cough and breathlessness. Imaging revealed MLS. Fiberoptic bronchoscopy visualised bluish-black hyperpigmentation with narrowing and distortion of right middle lobe bronchus suggestive of BAF. Transbronchial biopsy confirmed presence of lepidic adenocarcinoma. To our knowledge, this is the first detailed description of lepidic adenocarcinoma and BAF presenting as MLS.
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PMID:Middle lobe syndrome: An exceptional presentation of concomitant lepidic adenocarcinoma and bronchial anthracofibrosis. 2942

Surgery is one of the first-line treatments for thymic carcinoma. Middle lobe syndrome which is irresponsive to conservative therapies also calls for surgical intervention. We reported the case of a 65-year-old male who was diagnosed with coexistent thymic carcinoma and non-obstructive middle lobe syndrome. Before the operation, we took measures including repeated sputum examination, physical therapy, postural sputum drainage and bronchodilator inhalation. After removal of the mediastinal neoplasm, venous antibiotics were used to prevent pneumonia. The preexistent cough with purulent expectoration still lasted, but no pulmonary infection occurred. Our report indicates that middle lobe syndrome may not increase respiratory complications after midline sternotomy if it receives proper treatments before the operation. For patients with concurrent thymic carcinoma and persistent middle lobe atelectasis, the thymic tumor might be treated with priority to increase the chance of complete resection.
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PMID:Concurrent thymic carcinoma and middle lobe syndrome. 2960 97


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