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)

Children acquire blastomycosis, with rare exceptions, through the respiratory route. Nearly half of those who are infected may be asymptomatic. Cough is the most common symptom and is usually without sputum production, and hemoptysis is not noted. Other symptoms are chest pain (described as tightness or pain when breathing), weight loss, night sweats, and loss of appetite. The severity of illness is variable and may simulate an upper respiratory infection, bronchitis, pleuritis, or pneumonia. As in adults, an overwhelming infection may cause respiratory failure even in immunocompetent children and in immunocompromised children who live in or travel to endemic areas are susceptible to infection. Some reports based on consecutive cases note extrapulmonary dissemination commonly in children, whereas dissemination is rarely noted in outbreak cases. Chronicity of the disease favors extrapulmonary dissemination. Chest radiograph patterns are alveolar infiltrates, consolidation, and nodule(s), and these may be accompanied by cavitation. Diagnosis is suspected when the symptoms that mimic common respiratory infections persist for more than 2 weeks and by a history of residence or travel to an endemic area. Chest radiographic findings of nodule(s) or cavitation further increase the suspicion. Confirmation of diagnosis is by microscopic examination and culture of sputum. When expectorated sputum is unavailable, bronchoscopy with lavage and biopsy or percutaneous needle biopsy of lung is the appropriate next step. Disease that is progressive or severe or disseminated to other organs should be treated. Amphotericin B is effective and results in excellent cure rates. Experience using oral azoles is limited in children.
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PMID:Blastomycosis in children. 931 95

We report a case of 33 year old man who consulted us in 1994 for recurrent bronchitis sometimes with haemoptysis. The physical examination was unremarkable. At consultation abnormal fascicular sounds were noted at the left base. A chest x-ray showed hyperlucency of the left lung associated with a very small left hilar shadow. We considered the diagnosis of Mac Leod's syndrome after eliminating a proximal obstructive pathology and pulmonary embolus. Mac Leod's syndrome or Swyer James' syndrome was described in 1954 and is suggested on the standard radiograph above all if the expiratory films have confirmed the presence of air trapping. Angiography shows a slender and fine pulmonary network. Computer tomographic examination of the chest rules out a bronchial tumour, excludes bullous emphysema and reveals hyperlucent zones. Scintigraphy with ventilation perfusion supplies the essentials to understanding the mechanism (a syndrome of aerated lung which is neither directly ventilated nor perfused). The expiratory function tests most often show a restrictive syndrome but sometimes an obstructive syndrome is found with associated air trapping. The disorder does not progress and the prognosis is good.
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PMID:[Unilateral hyperlucent lung]. 949 8

Acute rejection after lung transplantation occurs commonly and is usually characterized histologically by a perivascular mononuclear infiltrate. We report five cases of pulmonary capillaritis with a histologic appearance distinct from typical rejection, occurring in patients ranging in age from 18 to 45 years, with a variety of underlying diseases including alpha1 antitrypsin deficiency, pulmonary hypertension, cystic fibrosis, and rheumatoid arthritis. Four of the five patients had alveolar hemorrhage histologically, and two had frank hemoptysis. Time of onset ranged from 3 weeks to many months after transplantation. Three cases were fulminant, and there were two deaths. In only one case, with methicillin-resistant Staphylococcus aureus bronchitis, could infection be established. All were treated with intensification of immunosuppressive therapy. Plasmapheresis was carried out in two cases and coincided with temporary improvement, but its efficacy was questionable because of concurrent immunosuppressive therapy. Two had recurrent biopsy-proven acute rejection within 6 weeks of treatment, and one had recurrent severe pulmonary hemorrhage that abated with total lymphoid irradiation. Our experience suggests that pulmonary capillaritis in lung transplant recipients can be an acute, fatal illness with the potential for recurrence in the survivors. We speculate that it represents a form of acute vascular rejection. Early pathologic diagnosis and aggressive immunosuppressive therapy are recommended. Although a humoral component was not documented, the possible response to plasmapheresis requires continued evaluation.
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PMID:Pulmonary capillaritis: a possible histologic form of acute pulmonary allograft rejection. 958 87

Pasteurella multocida has been implicated as the cause of a variety of respiratory conditions (eg, bronchitis, pneumonia, lung abscess, empyema), but hemoptysis has been noted only in conjunction with other lung conditions. We report a case in which hemoptysis was the sole manifestation of Pasteurella infection. The patient was a middle-aged man with severe obstructive lung disease and exposure to cats. Diagnosis was made by bronchoscopy and high-dose penicillin was required for resolution.
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PMID:Hemoptysis as the sole presentation of Pasteurella multocida infection. 959 62

Undetected foreign body aspiration is a well-known problem not only in children and patients with predisposing conditions like mental retardation, seizures or brain tumours, but also in healthy subjects. The clinical signs are quite different. Haemoptysis, cough, recurrent or chronic penumonia and bronchitis may occur. These symptoms are often accompanied by fever, weight loss and night sweat. Atelectasis, respiratory distress or death have been described. We demonstrate the case of a 39-year old man with Down syndrome who was transferred to our hospital because of pneumonia in the left lower lobe that had been lasting for about two months. It had been resistant to several antibiotic regimens. Computerised tomography led to the suspicion of a bronchial carcinoma with poststenotic infiltration of the lower lobe. Fibreoptic bronchoscopy and biopsy confirmed the diagnosis of a foreign body in the distal part of the left main bronchus. After two weeks of treatment with ciprofloxacin regression of the acute inflammation occurred. During a second bronchoscopy we could extract the foreign body (a 1 x 1.7 cm vertebra of a dove). It is concluded that undetected foreign body aspiration can occur in various clinical settings and fibreoptic bronchoscopy is a suitable approach providing an exact diagnosis.
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PMID:[Aspiration pneumonia caused by vertebrae of a dove in a 39 year old patient with Down syndrome]. 1044 52

The exact role of fibre-optic bronchoscopy (FOB) and CT of the chest in the diagnosis of patients presenting with haemoptysis and a normal or non-localizing chest radiograph has not been clearly defined. A study was designed to evaluate 50 patients presenting with haemoptysis and a normal or non-localizing chest radiograph using FOB and high-resolution computed tomography (HRCT). A definitive diagnosis was established in 17 (34%) patients. The aetiologies included bronchiectasis (24%), bronchial adenoma (6%), tuberculosis (2%) and bronchitis (2%). The diagnosis was made by HRCT in 15 (30%) patients, while FOB was diagnostic in five (10%) patients. The diagnosis was made by HRCT and FOB in all patients with focal airway abnormalities. Therefore, HRCT effectively delineated abnormalities of both the central and peripheral airways. It is concluded that CT should be obtained prior to FOB in all patients presenting with haemoptysis and a normal or non-localizing chest radiograph.
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PMID:Haemoptysis in patients with a normal chest radiograph: bronchoscopy-CT correlation. 1134 64

The incidence of bronchiectasis (BCT) has probably decreased in developed countries in recent years, but reliable statistical data on its occurrence are still lacking. The aim of the present study was to retrospectively evaluate the prevalence, age distribution and aetiology of BCT, diagnosed in a selected series of symptomatic patients of a Western country by using bronchography. The authors analysed the main known predisposing and associated conditions (PACs), and the occurrence and age distribution of BCT in 144 consecutive patients who underwent bronchological examination (fibreoptic bronchoscopy and bronchography) in the years 1987-1994 because of recurrent purulent bronchitis and/or haemoptysis. The overall prevalence of BCT was 34% (49/144); its age distribution was: 17.2% (0-10 yrs), 43.7% (11-20 yrs), 38% (21-30 yrs), 37.5% (31-40 yrs), 33.3% (41-50 yrs), 40% (51-60 yrs), and 20% (61-70 yrs). Thirty-one PACs were found in 29/144 patients of the whole study group. The prevalence of BCT was significantly higher in the subgroup of 29 patients with PACs than in the subgroup of 115 patients without PACs (75.9% versus 23.5%; p < 0000001). The aetiology of BCT was mainly unexplained, as it was only possible to detect 24 PACs in 22/49 patients with BCT (44.9%): congenital, genetic and immune disorders (eight), localized airways obstructive diseases (five), pulmonary infections (three), bronchial asthma (two), pulmonary lobar fibrosis (two), ulcerative colitis (two), dermatomiositis (one), and toxin inhalation (one). The authors conclude that bronchiectasis still occurs in a large percentage of symptomatic patients of a developed country in the post-antimicrobial era, especially in the second to sixth decades, as well as in the presence of predisposing and associated conditions; its aetiology remains unknown in more than half of cases.
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PMID:Prevalence, age distribution and aetiology of bronchiectasis: a retrospective study on 144 symptomatic patients. 1094 67

Haemoptysis is an alarming symptom, and the management depends upon the aetiology. Emergency management depends upon localization of the site of bleeding by roentgenogram, computerized chest tompgraphy and bronchoscopy. We prospectively evaluated 52 patients with haemoptysis admitted to the Chest Hospital, Kuwait for 1 year (January 1998 to December 1998) and followed them up for 1 year (January 1999 to December 1999). There were 42 males (80.8%) and 10 (19.2%) females, with a mean age of 42.2 (16-86) years. Of these, 26.9% were Kuwaiti nationals, 36.5% were Arab non-Kuwaiti nationals, 34.6% were Asians and 1.9% were other nationals. The aetiologies of haemoptysis were bronchiectasis (21.2%), old pulmonary tuberculosis with bronchiectasis (17.3%), active pulmonary tuberculosis (15.4%), bronchitis (5.8%), aspergilloma, rheumatic heart disease and carcinoid (1.9%). Aetiology could not be identified in 25% of patients. The site of bleeding in haemoptysis could not be localized by the consultants in 18 (32%) by roentgenogram. 16 patients (37%) by CT scan and 23 patients (50%) by Fibreoptic bronchoscopy. Sequential estimation of hemoglobin showed a mean of 13.56 (SD 1.9) and 13.31 (SD 1.8) after 24 h. The difference in mean was statistically significant (p<0.036). Conservative management was given in 80.8%, and embolotherapy or surgical intervention in 19.2% of patients. Only 12% of patients had recurrent haemoptysis at 1-year follow up. In conclusion, bronchiectasis and pulmonary tuberculosis were the major causes of haemoptysis in this study. Roentgenogram, CT scan and fibreoptic bronchoscopy are useful for localizing the site of bleeding. Sequential estimation of haemoglobin may be helpful in assessing the severity of haemoptysis, but larger studies are required to address this observation. The outcome of haemoptysis is generally good, with a low mortality and recurrence rate.
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PMID:Haemoptysis: aetiology, evaluation and outcome--a prospective study in a third-world country. 1145 10

Antineutrophil cytoplasmic antibodies (ANCA) are useful serologic markers for the diagnosis and management of patients with Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA). However, problems in diagnosis and classification may occur when patients with other disorders develop ANCA. A 7-year review (1993-1999) disclosed 247 patients whose sera tested positively for ANCA by an indirect immunofluorescence method: 166 patients for cytoplasmic-ANCA (C-ANCA) and 81 patients for perinuclear-ANCA (P-ANCA) Twenty-seven patients had active pulmonary disease and underwent open-lung biopsy or transbronchial biopsy. Eight patients (30%) had a disease other than WG or MPA, and their clinical, pathological, and serological findings were reviewed. The patients, all women, ranged in age from 28 to 77 years (median, 37 y). Dyspnea (n = 6), cough (n = 6), chest pain (n = 2), and/or hemoptysis (n = 2) were present. The duration of symptoms lasted from 3 weeks to 6 years (median, 6 mo). ANCA titers were C-ANCA (n = 4; range, 1:40-1280) or P-ANCA (n = 4; range, 1:40-640). The lung biopsies disclosed nonspecific interstitial pneumonia (n = 4), bronchiolitis obliterans organizing pneumonia (n = 1), diffuse alveolar damage (n = 1), organizing diffuse alveolar hemorrhage without capillaritis (n = 1), and necrotic granuloma (n = 1). No cases showed characteristic histology for WG or MPA. The final diagnoses were various connective tissue disorders (n = 5), chronic hypersensitivity pneumonia (n = 1), postinfectious bronchitis/bronchiectasis (n = 1), and ulcerative colitis-related lung disease (n = 1). Surgical pathologists should be aware that significantly elevated ANCA titers may be associated with diverse forms of pulmonary disease. ANCA positivity alone, in the absence of appropriate clinical or pathologic findings, should not be used to substantiate a diagnosis of WG or MPA.
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PMID:Antineutrophil cytoplasmic autoantibody in the absence of Wegener's granulomatosis or microscopic polyangiitis: implications for the surgical pathologist. 1242 4

Among 3498 patients with hemoptysis 513 had normal chest x-ray picture. Bronchoscopy performed in all these patients allowed to recognise malignant neoplasms of the lungs, trachea and pharynx in 109 patients. In 222 patients--nonspecific bronchitis and in 46--tuberculosis were recognised. In 86 patients diagnosis was not established.
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PMID:[Frequency and causes of hemoptysis and role of bronchoscopy in patients with normal chest roentgenogram hospitalized in the Department of Physiopneumonology Silesian Medical University in the years 1961-1996]. 1213 43


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