Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 63 year old women was hospitalized with massive hemoptysis, anemia and renal failure. Despite intensive supportive care, she died soon after admission. Autopsy revealed diffuse necrotizing alveolitis, rapidly progressive glomerulonephritis and a systemic vasculitis. Massive intrapulmonary hemorrhage with hemoptysis is an unusual complication of a systemic vasculitis. The case is discussed and the literature reviewed.
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PMID:Diffuse intrapulmonary hemorrhage, renal failure and a systemic vasculitis. A case report and review of the literature. 735 99

We report a 63 year old woman with a rapidly progressive renal failure and fever of unknown origin. Laboratory tests showed anemia, increased ESR and a urine analysis compatible with a glomerular disease. Antineutrophil cytoplasmic autoantibodies were positive with a perinuclear pattern. Kidney biopsy showed an autoimmune crescenteric glomerulonephritis. The patient had a bad evolution, dying after a massive hemoptysis. The necropsy showed a disseminated arteritis without compromise of bronchial vessels. The oligosymptomatic presentation of this patient, bearing in mind the anatomo-pathological findings, is noteworthy and emphasizes the usefulness of serological markers as antineutrophil cytoplasmic autoantibodies in the differential diagnosis.
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PMID:[Rapidly progressive kidney failure associated with neutrophil anticytoplasmic autoantibodies. Anatomo-clinical case]. 791 Jun 99

Anti-basement membrane antibody (anti-BM Ab) mediated disease is reported to be a rare disorder frequently leading to severe deterioration of renal function. It was our purpose to work out parameters necessary to predict the outcome reliably and to examine, who will benefit most from therapy. Data from 35 patients were evaluated retrospectively. Diagnosis was based on the detection of linear IgG staining (n = 28) along the glomerular basement membrane (GBM) in renal biopsies and/or on the demonstration of anti-BM Ab both by ELISA and immunoblotting (n = 35). Patients were followed up for at least 6 months. Several variables were analysed as to whether they are appropriate prognostic factors. Twenty patients (57%) presented with Goodpasture's syndrome, 13 (37%) had anti-GBM glomerulonephritis alone, whereas two patients suffered solely from pulmonary haemosiderosis. Frequent initial symptoms were haemoptysis (n = 18), haematuria (n = 26), proteinuria (n = 26) and elevated serum creatinine (n = 27). Among all, 10 patients improved, having stable renal function. Twenty-one patients developed end-stage renal failure and four died. Parameters indicating a poor prognosis were a serum(s)-creatinine greater than 600 mumol/l and crescent formation in more than 50% of the glomeruli on renal biopsy. By combining these two parameters the outcome could be reliably predicted. The initial antibody titre and cigarette smoking were without predictive value. In conclusion, the earlier therapy starts, the better will be the result. Patients presenting early with a serum creatinine < 200 mumol/l and without severe glomerular alterations gained the most benefit from therapy, indicating that outcome may be improved by early diagnosis.
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PMID:Course and prognosis of anti-basement membrane antibody (anti-BM-Ab)-mediated disease: report of 35 cases. 808 49

From 1984 to 1993, 48 thoracoabdominal aortic aneurysm resections were performed. The patient age ranged from 21 to 79 years (mean: 65.5 years), and the extent of the aneurysms were as follows: type I (most of descending and upper abdominal), 17 cases; type II (most of descending and most of abdominal), 3 cases; type III (distal descending and upper abdominal), 20 cases; and type IV (most or the entire abdominal aorta), 8 cases. Ten patients presented with ruptured aneurysms, 1 with hemoptysis, 20 with pain, and 20 with no symptoms. Operation was performed using simple aortic cross-clamping in 18 patients, distal perfusion via Gott shunt in 6, and heparinless left-heart bypass (Biomedicus pump) in 24. Intercostal or lumbar vessels were reimplanted into the graft in 13 patients. Aortic cross-clamp time was 25 to 115 minutes (mean: 49.6 minutes). Four of 10 patients (40%) with ruptured aneurysms and 3 of 38 (8%) patients with non-ruptured aneurysms died. Serious complications included paraparesis in 2 patients (5%), renal failure requiring dialysis in 2 (5%), stroke in 1 (2%), bleeding in 5 (12%), intraoperative cardiac arrest in 3 (7%), sepsis in 1 (2%), prolonged ventilation (longer than 3 days) in 11 (27%), and wound dehiscence in 2 (5%). Thoracoabdominal aneurysm resection remains a challenging problem but can be performed with acceptable risk in selected patients. Distal heparinless perfusion without a heat exchanger may help reduce the risk of paraplegia and renal failure.
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PMID:Experience with thoracoabdominal aortic aneurysm resection. 818 36

Side effects due to azathioprine (the nitroimidazole derivative of 6-mercaptopurine) can be classified as toxic (myelosuppression, hepatotoxicity) and idiosyncratic (fever, rigors, arthralgias, pneumonitis, and gastrointestinal symptoms). While the toxic effects are due to 6-mercaptopurine, the hypersensitivity reactions are believed to be caused by the nitroimidazole moiety. A 21-year-old male patient developed end-stage renal failure due to antiglomerular basement membrane (AGBM) disease (rapidly progressive glomerulonephritis with linear immunoglobulin G deposits and positive circulating AGBM antibodies). The patient became dependent on continuous ambulatory peritoneal dialysis and, later, hemodialysis, and received two renal allografts at the ages of 23 and 27 years. He received three courses of azathioprine treatment: one course for AGBM glomerulonephritis and two courses for rejection episodes. Each course was followed within 4 to 7 days by symptoms compatible with Goodpasture's syndrome, ie, high fever, rigors, arthralgias, diarrhea, myalgias, and pulmonary infiltrates with hemoptysis. All signs and symptoms always resolved completely on discontinuation of azathioprine. During the treatment for rejections, AGBM antibodies were not elevated, and during one episode AGBM disease in the lung (Goodpasture's syndrome) was excluded by open lung biopsy. Treatment of a subsequent rejection episode with 6-mercaptopurine was well tolerated. We conclude that azathioprine hypersensitivity can mimic the pulmonary manifestations of Goodpasture's syndrome. Hypersensitivity probably is due to the nitroimidazole moiety of azathioprine. Thus, differential diagnosis of Goodpasture's syndrome (and probably of any "pulmonary renal syndrome") should include azathioprine hypersensitivity.
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PMID:Azathioprine hypersensitivity mimicking Goodpasture's syndrome. 820 72

Primary vasculitis, include microscopic polyarteritis (MPA) and Wegener's granulomatosis (WG), is one of the causes of Glomerulonephritis and renal failure. Recently antineutrophil cytoplasmic autoantibodies (ANCA) is considered to be a very important tool for the diagnosis of MPA and WG. The management of ANCA was performed in 42 patients with variant primary glomerulonephritis with crescents formation or sclerotic glomerulonephritis, 5 of them show positive, appeared as a pattern of P-ANCA. Most of the patients were old male, with fever, malaise, weight loss, anemia, muscle and joint pain, some of them have chronic cough, even hemoptysis, opacities in middle-lower fields of both lungs, which didn't response to antibiotics therapy. This is the first report about renal involvement of primary vasculitis from China. Our result suggest that primary vasculitis is not a rare course of renal failure in China.
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PMID:[The renal involvement of primary vasculitis: clinical and pathological analysis of 5 cases]. 840 17

The problem with the emergence of HIV-associated tuberculosis (which usually occurs in young adults) is that attention has been diverted away from the fact that, in the developed world, the elderly represent the biggest pool of tubercular disease and therefore the greatest pool of infection within the community. Although the incidence rate of tuberculosis continues to decline in most countries, there is evidence from parts of the developing world that rates may be beginning to increase. The presentation of the disease in the elderly is often uncharacteristic, e.g. disease tending to be more insidious in onset, pyrexia often absent and haemoptysis less common. Chest x-ray changes may also mislead the clinician in that disease is frequently present in the mid or lower zones. The elderly are probably at greater risk of extrapulmonary tuberculosis, which also presents in uncharacteristic ways. The diagnosis remains based on clinical presentation and the presence of smear and culture positivity, although some patients may be treated in the absence of microbiological proof. Standard treatment is with a combination of isoniazid, rifampicin and pyrazinamide, with or without a fourth drug such as ethambutol. The incidence of adverse effects in the elderly is much greater than that in younger patients, often resulting in the need to change the medication to drugs which are better tolerated. This may require changing to regimens which are less effective and therefore have to be taken for a longer period of time. The presence of concomitant disease such as liver or renal failure may also necessitate the administration of a suboptimal regimen. Mortality in elderly patients with tuberculosis is considerably higher than that in younger patients, even when treatment appears to have been started on time; even in the developed world mortality exceeds 30% in those patients over 70 years of age.
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PMID:Tuberculosis in the elderly. Epidemiology and optimal management. 873 27

We describe a patient with idiopathic membranous glomerulopathy who developed acute deterioration in renal function; this was associated with hemoptysis, severe hypertension, and anti-glomerular basement membrane (anti-GBM) antibody in the serum. Despite aggressive therapy with plasmapheresis, cyclophosphamide and prednisone, the patient progressed to end-stage renal failure and is on maintenance hemodialysis.
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PMID:Goodpasture's syndrome superimposed on membranous nephropathy. A case report. 896 42

Goodpasture's disease is characterized by lung haemorrhage, associated with glomerulus basement membrane antibody glomerulonephritis, and circulating basement membrane antibody. Other diseases (Wegener, LES, arteritis) may have the same kidney and lung involvement. The Authors present a clinical case of rapidly progressive renal failure where renal biopsy showed an extensive extracapillary proliferative glomerulonephritis with linear deposits of antibody in the basement membrane, similar to Goodpasture's disease, with following lung involvement, but without hemoptysis and in absence of circulating antiglomerular basement membrane antibody. The Authors think it could be a case of Goodpasture's disease, even if it did not show the above-mentioned symptoms, whether out of the characteristic clinical course or the exclusion of all the other diseases. The Authors believe that the absence of circulating basement membrane antibody could be due to their sediment in the target organs and suggest a revision of the standards required for the Goodpasture's disease diagnosis.
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PMID:[Goodpasture's disease or syndrome? Apropos of a case]. 910 11

A 55-year-old man was admitted to our hospital with of hemoptysis, progression of anemia and renal failure in February, 1996. Idiopathic interstitial pneumonia had been diagnosed and he had been followed at a regional hospital since 1988. On the third day after admission, he suffered from sudden and massive hemoptysis. Goodpasture's syndrome was diagnosed because anti-GBM antibody was detected in serum. A high titer of MPO-ANCA was also recognized simultaneously. Steroid pulse therapy, immunosuppressive therapy, and plasmapheresis were begun, but he died on the 28th hospital day because of severe hypoxemia and multi-organ failure. Histological examination after autopsy revealed crescentic glomerulonephritis with linear deposition of IgG in the glomerular capillary wall, and interstitial pneumonia accompanied by massive alveolar hemorrhage. It was suggested that in this patient, not only anti-GBM antibody but also circulating MPO-ANCA might have participated in the progression of the crescentic glomerulonephritis and alveolar hemorrhage observed in Goodpasture's syndrome.
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PMID:[A case of Goodpasture's syndrome with myeloperoxidase specific anti-neutrophil cytoplasmic autoantibody (MPO-ANCA) during chronic interstitial pneumonia]. 956 81


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