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)

A 54-year-old nonasthmatic man was found to have allergic granulomatosis and angiitis (AGA) (Churg-Strauss syndrome) with pulmonary lesions suggestive of diffuse panbronchiolitis (DPB) at autopsy. The patient, with initial symptoms of cough and sputum, developed progressive dyspnea, eosinophilia, emaciation, fever, mononeuritis multiplex and myocardial infarction. The hypereosinophilic syndrome (HES) and DPB were suspected clinically. Corticosteroid therapy was not given at any time during the course. Autopsy revealed necrotizing, granulomatous angiitis affecting medium-sized arteries in many organs, extravascular granulomas in the interstitium of the heart and tissue infiltration by eosinophils. The heart showed widespread myocardial fibrosis and small foci of muscle fiber coagulation necrosis, which seemed to be the cause of death. In the lungs, the walls of respiratory bronchioles showed marked thickening with lymphocytic infiltration, lymph follicle formation and fibrosis. Accumulation of xanthoma cells was also observed. On the basis of the findings of clinical and pathological examinations, the patient was considered to have had DPB before the development of AGA.
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PMID:Allergic granulomatosis and angiitis (Churg-Strauss syndrome). Report of an autopsy case in a nonasthmatic patient. 321 17

We describe a patient with ulcerative colitis and extracolonic manifestations in whom diffuse interstitial pulmonary disease developed that was responsive to glucocorticoid therapy one year after total proctocolectomy. The patient presented in December 1983 with a subacute course marked by cough and progressive exertional dyspnea, abnormal chest examination results, and a chest roentgenogram that revealed diffuse interstitial and alveolar infiltrates. A transbronchial biopsy specimen revealed a polymorphic interstitial infiltrate, mild interstitial fibrosis without apparent intraluminal fibrosis, and no vasculitis, granulomas, or significant eosinophilic infiltration. Within one week of the initiation of daily high-dose steroid therapy, the patient's symptoms dramatically improved; chest roentgenogram and forced vital capacity (60%) improved at a slower rate. All three measures deteriorated when alternate-day prednisone therapy was started but once again improved until the patient was totally asymptomatic, chest roentgenograms were normal, and forced vital capacity was 80% of the predicted value 2 1/2 years later.
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PMID:Ulcerative colitis and steroid-responsive, diffuse interstitial lung disease. A trial of N = 1. 337 24

We have analyzed an unusual group of 19 patients (15 previously reported) with Wegener's granulomatosis, who presented with severe glomerulonephritis and developed diagnostic respiratory lesions only after 4 to 78 months. Necrotizing glomerulonephritis, often with crescents, and rarely with vasculitis, was the predominant renal lesion. Wegener's granulomatosis was unsuspected initially, since systemic manifestations, such as fever, arthralgias, malaise, and even pulmonary hemorrhage, were nonspecific or transient, and because renal biopsy findings resembled those seen in microscopic polyarteritis or idiopathic crescentic nephritis. Despite therapy, usually with corticosteroids, only 4 patients maintained adequate renal function. Most patients were receiving chronic dialysis when respiratory involvement developed. Cavitary nodular pulmonary infiltrates were seen in 12 of the 17 patients with lung involvement, and otorhinological disease occurred in 10 patients. Arthralgias, fever, and cough, with or without hemoptysis, were common. Wegener's granulomatosis was diagnosed by lung biopsy in 15 cases and by nasal biopsy in 4. Specific treatment was required for the respiratory disease and was delayed in many patients, because of lack of awareness that Wegener's granulomatosis may present with primary glomerulonephritis and become active during chronic renal failure or dialysis. Nevertheless, all but 1 patient eventually responded to treatment, although 3 additional patients died of late complications.
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PMID:Severe glomerulonephritis with late emergence of classic Wegener's granulomatosis. Report of 4 cases and review of the literature. 357 16

Giant-cell or temporal arteritis is a generalized vasculitis that predominantly affects large- and medium-sized arteries in people over 50 years of age. The illness is commonly characterized by the initial symptoms of headache, temporal artery tenderness or pulselessness, musculoskeletal pain, fever, and fatigue. The most dreaded consequence of giant-cell arteritis is visual loss, which is usually irreversible on presentation. Giant-cell arteritis may present with unusual clinical manifestations such as lip, scalp, and tongue necrosis, carpal tunnel syndrome, claudication of the limbs, strokes, angina pectoris, myocardial infarction, hematuria, cough, or other CNS symptoms. The etiology of the disease is unknown. Emergency physicians are usually familiar with the more common clinical symptoms but one must consider the unusual manifestations of the disease, because early recognition and initiation of therapy (steroids) decrease morbidity and can prevent blindness.
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PMID:Giant-cell arteritis. 379 80

The clinical and autopsy records of 65 patients with either polymyositis (24) or dermatomyositis (41) and pulmonary disease were reviewed. Pulmonary symptoms were recorded in 43 of the cases and included dyspnoea in 31, cough in 23, and chest pain in six. Interstitial lung disease was noted at autopsy in 27 patients; almost half of these had arthritis. Bronchopneumonia was found in 35 patients, 31 of these had received prednisone. Dysphagia was present in a similar proportion of patients with and without pneumonia. Pulmonary vasculitis was seen in five patients; pulmonary symptoms, arthritis, and raised erythrocyte sedimentation rate were present in four of these cases and all five had associated interstitial lung disease. Other pulmonary manifestations included pulmonary oedema, primary pulmonary malignancy, diffuse alveolar damage, fibrinous pleuritis, pulmonary emboli, and diaphragmatic atrophy. The mean survival after disease onset was 29 months but was much less for those with interstitial lung disease and pulmonary vasculitis.
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PMID:Pulmonary disease in polymyositis/dermatomyositis: a clinicopathological analysis of 65 autopsy cases. 381 71

In this study, we report the case of a 48 year-old female patient showing a clinical picture after a month's evolution consisting of cough, moderate effort dyspnoea, asthenia, anorexia and loss of weight. One year before, she had been diagnosed with bronchial asthma and she had been treated for two years with policarpine collyrium for a glaucoma simplex. The exploration only showed the existence of iris synechias in the right eye and conjunctival hyperaemia on the same side, together with basal crepitant rales on auscultation. Once we had proved the existence of a peripheral eosinophilia superior to three thousand elements per mm3 and of peripheral pulmonary infiltrates with radiographic negative for pulmonary edema, the picture was included in the so-called P.I.E. syndrome whose various etiologies were discarded subsequently. Following a pharmacological survey, a study of parasites in faeces and cutaneous tests as well as provocative tests, the specific causes of P.I.E. were discarded. According to the transbronchial biopsy and the biopsies of skin, nerve and muscle, it was unlikely that the diagnosis would be granulomatosis and/or angiitis. No evidence was found of any of the affections in which P.I.E. is regarded as a minor component. In view of the above, we thought the correct diagnosis was chronic eosinophilic pneumonia, since all the characteristics defining this picture according to Carrington were fulfilled. The treatment was started with corticoids and a clear improvement of all clinical symptoms was observed, including the ocular findings and the disappearance of radiographic pulmonary infiltrates.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Apropos of a case of chronic eosinophilic pneumonia associated with iridocyclitis and bronchial asthma]. 383 34

We report a case of extrinsic allergic bronchiolo-alveolitis associated with handling of mouldy lichen. The patient had periodic dyspnoea, cough and mucoid sputum, and a micronodular infiltration of both lungs with slight restrictive ventilatory insufficiency. An open lung biopsy showed interstitial inflammation and fibrosis with sarcoid granulomas and angiitis. The symptoms disappeared during long term corticosteroid therapy, but reappeared every year when the patient participated in the handling of lichen (Cladonia alpestris). Precipitating antibodies against Aspergillus fumigatus, A. umbrosus, and Thermoactinomyces vulgaris, were detected in the patient's serum, and against a mixture of fungi including A. terreus, Rhizopus spp., Cladosporium spp., and Penicillium spp., isolated from mouldy lichen storage boxes. After she retired, her symptoms disappeared and the lung function tests showed a slight improvement. In Northern Finland, farmers generally participate in lichen collection. Antigens from mouldy hay and from mouldy lichen may represent a double occupational hazard for them.
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PMID:Pulmonary fibrosis, with sarcoid granulomas and angiitis, associated with handling of mouldy lichen. 665 92

A 26 year-old woman first complained at a sparse sputum stained with blood. 18 days later haemorrhagic petechias on the lower limbs skin appeared and rapidly disappeared. The gradually enhancing cough was followed by haemoptysis and bleeding. The death occurred at the 41st day of the disease from persisting lung bleeding. The cause of lung bleeding was Wegener's granulomatosis which was characterized by destructive angiitis, haemic and tissue eosinophilia, lymph node granulomatosis and diffuse glomerulonephritis.
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PMID:[Case of Wegener's granulomatosis]. 672 7

We described three cases of eosinophilic pneumonia of unknown aetiology investigated clinically and by lung biopsy. The illnesses lasted between six and 20 weeks and consisted of cough, dyspnoea, malaise, and in two cases prolonged pyrexia. All had blood eosinophilia and chest radiographs showing widespread bilateral shadowing; in two cases this had a characteristic peripheral distribution. One patient recovered spontaneously and the other two responded to steroids, with disappearance of pyrexia within 12 hours and radiological clearing within 14 days. Lung function tests during the acute illness showed volume restriction or gas transfer defects or both in two cases. After remission all three showed abnormalities if small airways function. Lung biopsies performed during the acute illness were examined histologically and by transmission electron microscopy, and in two cases by immunofluorescence. There was both intra-alveolar and interstitial eosinophilic pneumonia with bronchiolitis obliterans, microgranulomata, and a vasculitis. Electron microscopy showed numerous eosinophils, many degranulated, and macrophages with phagocytosed eosinophilic granules and intracytoplasmic inclusions. In one case IgM, IgG, and IgA were demonstrated in the bronchial walls and interstitium. No IgE or complement was present. We believe that eosinophil granules are responsible for the tissue damage and fever and suggest mechanisms for this and for the response to steroid therapy.
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PMID:Chronic eosinophilic pneumonia. 700 96

There is a broad spectrum of disease encompassed by the various forms of eosinophilic pneumonia. Variations in both clinical course and histologic picture make these conditions difficult to classify. A case is reported of an 18-year-old black female, seven weeks postpartum, who presented with distinctive subcutaneous nodules on her extremities. These progressed to include edema and pruritus of both feet and one arm. She had been taking only oral contraceptives for six weeks. While in the hospital, she developed fevers to 104 F, cough, shortness of breath, and eventual respiratory insufficiency requiring intubation and ventilatory assistance. Chest x-ray films revealed diffus infiltrates. Lung biopsy revealed chronic interstitial organizing pneumonia with vasculitis and marked eosinophilia. She responded dramatically to high dose steroids and recovered. After careful literature review, this case fits best in the category of Carrington chronic eosinophilic pneumonia. It is unusualy in its dermatologic presentation and its fulminant development of respiratory insufficiency.
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PMID:Eosinophilic pneumonia. 735 88


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