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)

Sera from 245 patients were screened by indirect immunofluorescence for perinuclear/nuclear staining (P-ANCA) of ethanol-fixed neutrophils, a staining pattern which is associated with the presence of antibodies to myeloperoxidase. Using immunoblot and immunoprecipitation techniques on 15 P-ANCA-positive sera, 13 patients demonstrated antibody to purified or native myeloperoxidase but not to denatured myeloperoxidase. In patients with P-ANCA, the most frequent reason for medical attention was hemoptysis (8/13; 62%). Of the 15 sera with P-ANCA, acute renal failure was identified in 9 patients (60%). Five patients (33%) had both. All patients (eight of eight) with hemoptysis had antibodies which bound functional MPO as compared to three of seven P-ANCA-positive patients without hemoptysis (P less than 0.001), suggesting that antibodies which recognize conformational sites on native myeloperoxidase occur in a subgroup of patients with alveolar hemorrhage as their presenting clinical sign. These findings may provide insight into the disease process associated with P-ANCA. We further identify a subgroup of patients with a severe pulmonorenal syndrome and antibodies recognizing native myeloperoxidase.
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PMID:Autoantibodies to native myeloperoxidase in patients with pulmonary hemorrhage and acute renal failure. 166 24

In contrast to the panarteriitis nodosa macroform, the lung is frequently involved in p-ANCA-positive microvasculitis. Alveolar capillaritis, which may improve under immunosuppressive therapy, is a characteristic feature of this microvasculitis. We report on an 82-year-old patient who was admitted to the hospital because of severe hemoptysis due to microvasculitis. He died 3 weeks later despite therapy with steroids and cyclophosphamide. At autopsy alveolocapillary microaneurysms were found that may be residues of alveolar capillaritis.
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PMID:[Alveolocapillary microaneurysm in p-ANCA positive microvasculitis (microform of panarteritis nodosa)]. 766 14

A 77-year-old man was admitted because of hemoptysis. Chest roentgenograms initially showed progressive infiltrative shadows, which improved spontaneously in 3 months. Transbronchial lung biopsy specimens obtained during the first admission revealed alveolar hemorrhage with neither granuloma nor vasculitis. Alveolar hemorrhage associated with renal dysfunction recurred 9 months later. Serum creatinine level was elevated to 3.5 mg/dl. No other organ than lungs or kidneys was involved. Renal biopsy was performed to confirm the pathological diagnosis of crescentic glomerulonephritis. Anti-basement-membrane antibody was negative, whereas anti-neutrophil-cytoplasmic antibody was positive for perinuclear pattern (P-ANCA) by indirect immunofluorescent (IF) method. He was diagnosed as having idiopathic crescentic glomerulonephritis complicated with alveolar hemorrhage, and the presence of anti-myeloperoxidase (MPO) antibody in serum was anticipated. Anti-MPO antibody level in his serum evaluated by ELISA was markedly elevated. Although myeloperoxidase has been considered as a common antigen to P-ANCA and anti-MPO antibody, the determination of P-ANCA has been clinically unreliable because of equivocal results. In contrast, the presence of anti-MPO antibody is highly specific for idiopathic crescentic glomerulonephritis complicated with alveolar hemorrhage or its incomplete variant case. Also, it is a better index of disease activity. Therefore, there is a possibility that those patients diagnosed as having idiopathic pulmonary hemosiderosis or pulmonary-renal syndrome may be categorized into the one disease, anti-MPO antibody-associated disease, and the measurement of anti-MPO antibody may lead to prompt treatment prior to the histological diagnosis.
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PMID:[A case of crescentic glomerulonephritis associated with anti-myeloperoxidase antibody presenting as alveolar hemorrhage]. 818 51

The microscopic polyarteritis is a vasculitis related to necrotizing glomerolunephritis. It always damages at renal and systemic level (a third of the cases presented hemorrhage alveolar). We have showed a case that took place with hemoptysis and renal progressive insufficiency. Among the patient antecedents, we can find arterial hypertension hematuria, rhinitis, epistaxis and artromyalgias. Just before his admittance it showed edemas on lower limbs and eyelids, dysnea, severe hemoptysis, paresthesias and general malaise. The immunologic analysis: Acs. glomerular basal antimembrane: negative, ANCA positive with antimieloperoxidasa specificity. The renal biopsy: focal necrotizing glomerulonephritis with semilunar and negative immunofluorescent. The nasas biopsy: unspecified chronic rhinitis. From the clinic point of view, the patient seemed to have the Wegener granulomatosis apart from the fact that he had hemoptysis which is a rare sign in this cases. However, we could not find any granuloma anatomopatologically, which did not clarify this diagnosis. We diagnosed microscopis Poliarteritis, as a third of the cases presented intrapulmonary haemorrhage. Moreover the renal damage it is identical than in the in Wegener granulomatosis. On the top of that, often we can find p-ANCA, which confirms the diagnosis in 99% of cases. Despite our doubt according to the diagnosis the therapeutical treatment of both illnesses is nowadays identical. This means that we were able to begin a precocious treatment with plasmapheresis, metilprednisolona and ciclofosfamida. After a week treatment there was an evident improvement. Five moth later the illness relapsed.
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PMID:[Microscopic polyarteritis]. 892 53

We encountered two patients with pulmonary hemorrhage who had high levels of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA). Patient 1 was a 69-year-old woman. Both were admitted to our hospital complaining of hemoptysis. Microscopic hematuria was detected in patient 1, and proteinuria and renal insufficiency were detected in patient 2. Chest X-ray films showed bilateral patchy infiltrates in patient 1, and right middle-lower infiltrates in patient 2. In both patients the levels of MPO-ANCA were high and the results of tests for anti-basement membrane antibodies were negative. These patients were suspected to have pulmonary-renal vasculitic syndrome with a high level of MPO-ANCA. In patient 1, because the level of MPO-ANCA decreased after treatment with steroid therapy, we believe that measuring the level of MPO-ANCA was useful in the management of the disease. Rapidly progressive glomerulonephritis developed in patient 2, and was exacerbated despite hemodialysis, steroid therapy, and plasma exchange therapy. Use of the term microscopic polyangiitis (MPA) was first proposed by yhe Chapel Hill Consensus Conference in 1993. MPA, which was formerly called microscopic polyarteritis nodosa, connotes pauci-immune necrotizing vasculitis affecting arterioles, venules, or capillaries, and this condition is strongly associated with ANCA. Patients with pulmonary-renal vasculitic syndrome who have MPO-ANCA may be given a diagnosis of MPA. Therefore, we diagnosed MPA in these two patients. Testing for ANCA may be useful in patients with pulmonary hemorrhage and renal involvement.
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PMID:[Two patients with pulmonary hemorrhage associated with myeloperoxidase-antineutrophil cytoplasmic antibody]. 907 Nov 67

An 86-year-old woman was admitted with hemoptysis and rapid deterioration of renal function. Renal biopsy disclosed necrotizing crescentic glomerulonephritis. Based on positivity for serum myeloperoxidase antineutrophil cytoplasmic autoantibody (MPO-ANCA), MPO-ANCA-associated glomerulonephritis was diagnosed. Steroid pulse therapy was performed, but the patient died after the second course. Autopsy revealed renal vasculitis with fibrinoid necrosis extending to the level of the arcuate arteries. Vasculitis was also observed in the liver, adrenal gland, uterus, and spleen, suggesting the presence of microscopic polyarteritis. This case demonstrates the broad spectrum of MPO-ANCA-positive vasculitis and suggests the need for a more effective therapy suitable for very elderly patients.
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PMID:Myeloperoxidase antineutrophil cytoplasmic autoantibody-associated glomerulonephritis in a very elderly patient with generalized vasculitis at autopsy. 935 70

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

An 80-year-old woman presented at our hospital on October 1995 with fever, hemoptysis and a cavitary shadow on chest X-ray. Blood examination revealed an accelerated erythrocyte sedimentation ratio and elevated CRP. Pulmonary cryptococcosis was suspected, but serological tests and bronchoscopic examination for cryptococcus were both negative. There was also no evidence of the tuberculosis or malignancy. She was treated with the antibiotic cefpirome sulfate intravenously for thirteen days. Her chest X-ray and abnormal blood test findings became almost completely normal following the i.v. antibiotic treatment. In February 1996 (2 months after her first admission), she had severe right cheek pain, and Coldwell Luc's operation was performed after right maxillary sinusitis was diagnosed. A high fever (39 degrees C) continued after surgery, and multiple cavitary shadows were seen on chest X-ray. Blood examination revealed an accelerated ESR, elevated CRP and slightly elevated c-ANCA. She was treated with i.v. infusion of antibiotics and antifungal drug's, but did not improve. Wegener's granulomatosis was diagnosed after transcutaneous lung biopsy and histopathological examination of the maxillary sinus. Dramatic improvement was seen following treatment with oral cyclophosphamide and prednisolone. Whether her first remission was due to antibiotic treatment or spontaneous is an interesting question.
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PMID:[A case of Wegener's granulomatosis which showed early spontaneous remission]. 965 73

In May 1984 a 58-year-old woman presented with a broad spectrum of clinical symptoms including malaise, arthralgia, hemoptysis and dyspnea, proteinuria and hematuria and a vasculitic necrotizing rash. Bronchial biopsies revealed subglottic granulomatous lesions and renal biopsies showed necrosis, extracapillary proliferation and crest formation, confirming the diagnosis of Wegener granulomatosis. Positive c-ANCA and anti-proteinase 3 subfraction (anti-PR3) titers were first analysed in 1991. Clinical remission was achieved by standard immunosuppressive therapy and renal function was stabilised. Several minor relapses were treated with pulsed intravenous cyclophosphamide but the symptoms could not be completely controlled. Eight years after the onset of disease, a dramatic increase in anti-PR3 titers was observed (34438 U/ml, normal range < 10, ELISA), followed 3 months later by a clinically apparent relapse. Immunosuppressive therapy was reinstituted without clinical improvement. At this point plasmapheresis resulted in an amelioration of clinical symptoms as well as a reduction in anti-PR3 titers. Concomitant immunosuppressive therapy was administered with oral corticosteroids. Forty days later anti-PR3 titers increased, reaching 75000 U/ml twelve months later, however this time without associated clinical symptoms. During the following months the patient had a further transient deterioration of pulmonary and renal function due to secondary bacterial infection which was successfully treated with antibiotics. A nephritic sediment was not present during these episodes. Curiously, the anti-PR3 titers have remained excessively elevated for the last three years.
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PMID:Dissociation between high anti-PR3 titers (c-ANCA) and the clinical course of disease in a case of Wegener granulomatosis. 982 23

A 56-year-old woman was hospitalized for recurrent hemoptysis. She had been suffering from bronchiectasis for 4 years. Pseudomonas aeruginosa was persistently detected in her sputum. Serum was positive for Myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) and bactericidal/permeability-increasing protein antineutrophil cytoplasmic antibody (BPI-ANCA). She underwent lung resection. Histopathologically, the resected lung showed bronchiectasis with pulmonary fibrosis but did not show vasculitis. Her serum became negative for the ANCAs after the operation. To date, she has no recurrence of hemoptysis. We discuss this case of bronchiectasis with MPO-ANCA and BPI-ANCA and suggest a possible role for ANCAs in chronic airway infection.
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PMID:Bronchiectasis with myeloperoxidase antineutrophil cytoplasmic antibody and bactericidal/permeability-increasing protein antineutrophil cytoplasmic antibody. 1052 46


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