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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report, through this observation, a rare case of Wegener's disease revealed by myocarditis associated with fibroblastic endocarditis. The patient was initially admitted to hospital with global heart failure. The ECG showed atrial flutter rhythm disorder. Echocardiographic examination revealed non-dilated left ventricle with severe dysfunction and positive troponin dosage. Severe renal failure was discovered fortuitously and required hemodialysis. It was associated with an inflammatory anaemia confirmed by serum ferritin and myelogram. c-ANCA dosage was strongly positive, confirming the diagnosis. Chest CT scanning objectified right basal pneumonia. After starting appropriate treatment, including corticotherapy and immunosuppressive treatment, evolution was favorable with the normalization of left ventricular systolic function. Although obvious clinical cardiac events are rare, cardiac involvement in Wegener's disease is described, requiring rapid diagnostic orientation and rigorous knowledge of this serious disease.
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PMID:[A rare mode of revelation of Wegener's granulomatosis: myocarditis associated with a fibroblastic endocarditis]. 2727 60

Flexible fiberoptic bronchoscopy is often the initial technique for diagnosis of lung and bronchial tumors. Many studies have shown the high accuracy rate of bronchial washing and brushing cytology in the evaluation of neoplastic and non-neoplastic bronchopulmonary lesions. The aim of this study is to emphasize the value of the bronchial cytologic findings for diagnosis of non-neoplastic bronchopulmonary lesions. In a cross-sectional study, we retrieved all cases with bronchial washing and brushing cytology from 21 Mach 2014 to 21 December 2015. The slides of 100 patients with negative cytological reports were reviewed and concomitantly correlated with history, physical examination, clinical and pathologic documents. The cases with insufficient clinical and pathological diagnostic documents were rejected. The results classified in subgroups according to final diagnosis and cytological findings were discussed. We evaluated 100 cases that were previously had negative cytological reports.60 cases were male, and 40 cases were female with male to female ratio: 6/4. The age range was between 21 to 88 with the mean age of 57 years. Regarding lung cancer, 31% of cases were false negative. Causes of these falsely negative reports were been errors in screening, low cellularity, unsatisfactory smears and poor fixation. 23% were known cases of tuberculosis with some cytological findings including inflammation, necrotic calcified deposits, multinucleated giant cell and reserve cell hyperplasia. 19% were pneumonic patients with smears demonstrating inflammation, curschmann's spiral and reserve cell hyperplasia. Other non-neoplastic cases included in this study were asthma, granulomatous inflammation, rheumatoid arthritis, sarcoidosis, Wegener, SLE, heart failure, hydatid cyst, interstitial lung disease, and end stage renal disease. Cytological specimens from patients underwent bronchoscopic washing and brushing should be carefully examined. In situations with negative cytologic results, correlation with history, imaging and biopsy specimen is mandatory.
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PMID:Efficacy of Bronchial Washing and Brushing Cytology in the Diagnosis of Non-Neoplastic Lung Diseases. 2922 29

BACKGROUND Granulomatosis with polyangiitis (GPA)/Wegener's granulomatosis (WG) and eosinophilic granulomatosis with polyangiitis (EGPA)/Churg-Strauss' syndrome (CSS) are ANCA (antineutrophil cytoplasmic antibodies) associated vasculitides that can affect the heart, predominantly the myocardium. Valvular affection is rare and is described anecdotally. The purpose of this case report was to present aortic valve affection of an ANCA positive vasculitis. CASE REPORT We present the case with a 56-year-old male diagnosed with ANCA associated vasculitis, who began experiencing respiratory symptoms primarily thought to be respiratory tract affection. These symptoms worsened, and an echocardiography revealed heart failure with decreased left ventricular ejections fraction (EF=30-35%) and a severe insufficiency of the aortic valve. The patient underwent aortic valve replacement with symptomatic relief. Pathological examination of aortic valve resectates revealed inflammation and thickening of the aortic cusps. CONCLUSIONS Patients with ANCA associated vasculitis can rarely present with valvular inflammation causing severe regurgitation. The aortic valve can be involved, although cases have also described mitral valve involvement and both valves simultaneously. In patients with ANCA associated vasculitis a severe worsening of dyspnea can be caused by exacerbation of pulmonary involvement, but severe valvular disease should also be considered.
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PMID:Anti-Neutrophil Cytoplasmic Antibody (ANCA) Associated Vasculitis Causes Aortic Valve Degeneration and Severe Aortic Regurgitation. 3093 Apr 60


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