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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The occurrence of hemoptysis, dyspnea, and bilateral pulmonary opacities progressed to respiratory failure in a 34-yr-old man. Recovery occurred with corticosteroid therapy. In the absence of evidence for an infectious etiology, the possibility of immunologic trimellitic anhydride (TMA) hemorrhagic pneumonitis was considered when the lung biopsy excluded Goodpasture's and other diseases and because the patient was a spray painter. Serologic evaluation for antibodies against TMA was requested. Because the immunologic studies for TMA were negative, and because the patient was a spray painter, immunoassays for three isocyanates conjugated to human serum albumin (HSA) were carried out although there was no specific history of isocyanate exposure at that time. High levels of IgG and IgE antibodies were detected against hexamethylene diisocyanate (HDI)-HSA and toluene diisocyanate (TDI)-HSA. Further investigation documented exposure to spray paint that contained HDI and another isocyanate. The paint was sprayed on warm metal, and subsequently the worker developed an acute illness. Further plant studies were not possible. We propose that the pathogenesis of this case of hemorrhagic pneumonitis is immunologic because of uncontrolled exposure to HDI and TDI, is analogous to the immunologic hemorrhagic pneumonia caused by TMA, and should be considered as a possible cause of a similar acute lung disease after isocyanate exposure.
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PMID:Immunologic hemorrhagic pneumonia caused by isocyanates. 215 56

In this report, we review the hospital course of four patients who presented with an acute pulmonary syndrome after inhaling freebase cocaine and compare them with previously described case reports. Two patients had prolonged inflammatory pulmonary injury associated with fever, hypoxemia, hemoptysis, respiratory failure, and diffuse alveolar infiltrates. Lung tissue specimens from both patients revealed diffuse alveolar damage, alveolar hemorrhage, and interstitial and intraalveolar inflammatory cell infiltration notable for the prominence of eosinophils. Immunofluorescent staining performed on one of the biopsy specimens showed a striking deposition of IgE in both lymphocytes and alveolar macrophages. Both patients were treated with systemic corticosteroids and rapidly improved. In contrast, two patients presented acutely with diffuse pulmonary alveolar infiltrates associated with dyspnea and hypoxemia, but without fever, and within 36 h of discontinuing cocaine their pulmonary infiltrates and symptoms had spontaneously resolved. Our report further supports the finding that an acute pulmonary syndrome can occur after inhalation of freebase cocaine. Furthermore, the lung injury may respond to systemic corticosteroid therapy when it is associated with a prominent inflammatory cell infiltration.
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PMID:Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. 238 9

A patient is described with an asymptomatic exacerbation of allergic bronchopulmonary aspergillosis (ABPA), clinically characterized by pulmonary infiltrates, with absence of obstructive reactions and a short period of hemoptysis 2 weeks before hospitalization. Cell counts and antibody concentrations were measured in serum, and bronchoalveolar fluid (BAF) samples and values were compared with data from previous periods of symptomatic exacerbations. During the asymptomatic exacerbation, concentrations of antibody to Aspergillus fumigatus, total IgE, and precipitating antibodies were elevated in peripheral blood. No quantitative differences in specific antibody concentrations (IgE, IgG, IgA, and IgM) against A. fumigatus were found between sera from symptomatic and asymptomatic periods of ABPA. In contrast to observations in the serum, protein concentrations in BAL fluid were normal during the asymptomatic period, whereas high concentrations were found during the symptomatic phases. Local antibody concentrations (in BAF) were characterized by high levels of IgA antibodies against A. fumigatus. During asymptomatic and symptomatic phases, eosinophils were elevated in peripheral blood, in sputum, in BAF, and highly elevated in tissue biopsy specimens. Activated eosinophils were found, as indicated by the presence of light-density cells in the circulation and monoclonal antieosinophil cationic protein binding to bronchoalveolar lavage eosinophils. In contrast to the symptomatic phase of ABPA in 1980, demonstrating aspecific airway reactivity to several pharmacologically active substances, no such hyperreactivity was found during the asymptomatic phase of ABPA in 1986. It is proposed that the asymptomatic infiltrative phase of ABPA is an intermediate stage that can develop into a symptomatic phase after prolonged and intensified infiltration of eosinophils. Mediators from the inflammatory cells may be involved in the induction of bronchial hyperresponsiveness. After induction of this hyperreactive stage of the airways, additional liberation of mediators from either eosinophils and/or mast cells will lead to a symptomatic (obstructive) phase of ABPA.
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PMID:Cellular and humoral observations in a patient with allergic bronchopulmonary aspergillosis during a nonasthmatic exacerbation. 270 43

We report a 15-year-old male with bronchial asthma since five years old, unresponsive to treatment; at age 12 a diagnosis of pulmonary tuberculosis was made and treated with several drugs. He was referred to our hospital because of hemoptysis. A diagnosis of aspergillosis in the aspergilloma form was made; after, a left upper lobectomy showed the invasive form; later he presented recurrent obstructive respiratory problems, secondary to the allergic form. Serum IgE was elevated, lowering after treatment with corticoids; simultaneously he had clinical improvement. Treatment was discontinued when clinically asymptomatic and serum IgE was normal. Diagnostic route and treatment are discussed.
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PMID:[Pulmonary aspergillosis]. 271 51

We report a patient who developed asthma associated with exposure to cats. During his evolution he presented pulmonary infiltrates accompanied by eosinophilia in blood and sputum, hemoptysis and flu-like symptoms. The sera contained specific IgE and precipitating antibodies to cat epithelium. After a year without contact with cats, precipitating antibodies were negative, and a bronchial provocation test only demonstrated an immediate response.
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PMID:Cat sensitization provoking asthma and pulmonary infiltrates with eosinophilia. 322 49

A 47-year-old man with a history of mild asthma presented with hemoptysis attributed to a large multiloculated cavitary mycetoma. Peripheral blood eosinophilia of 43 percent led to the diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Treatment of ABPA with prednisone led to resolution of an upper lobe infiltrate and a dramatic reduction in the total serum IgE level. Evaluation over a two-year period did not demonstrate enlargement of the cavity or disseminated aspergillosis.
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PMID:Allergic bronchopulmonary aspergillosis and aspergilloma. Long-term follow-up without enlargement of a large multiloculated cavity. 669 Feb 37

The clinical and immunologic features of ten patients with allergic bronchopulmonary aspergillosis (ABPA), observed over periods varying from 12 months to 10 years, are reported. Acute attacks of ABPA were characterized by several, or all of: increased cough and sputum, haemoptysis, pleuritic pain, expectoration of sputum plugs, and increasing airways obstruction. Peripheral blood eosinophilia and acutely elevated serum IgE levels were seen in all patients during acute attacks, sputum eosinophilia and recovery of Aspergillus in sputum was less common. However, blood eosinophilia was not present in all attacks of ABPA and sputum eosinophilia varied similarly from one attack to another. Six patients with previously documented multiple precipitin lines have had no demonstrable precipitins to Aspergillus on several occasions between attacks, three of these patients have also been negative during attacks. Five of the six patients have again developed positive precipitin lines. The total number of episodes in these ten patients was fifty two, three patients have had more than nine acute attacks of ABPA. There is no seasonal variation in this group of patients. Since diagnosis, only three patients have had an attack-free interval longer than 12 months. Two patients are steroid-dependent because of severe asthma, and nine have symptoms of bronchiectasis.
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PMID:Experience with allergic bronchopulmonary aspergillosis: some unusual features. 669 71

Bronchopulmonary infections with Aspergillus give rise to three different pathological entities. Allergic bronchopulmonary aspergillosis, found in patients with an atopic predisposition, is marked by dyspnea of the asthmatic type associated with labile radiologically detectable infiltrates, blood hypereosinophilia, enhanced total IgE levels, specific IgG fractions, and positive immediate reactions to skin tests. The long-term risk is the development of proximal bronchiectasis. Dosage and duration of corticotherapy are function of eosinophilia and total IgE levels. Pathogenicity is similar to that of extrinsic allergic alveolitis, probably involving disturbances in immune complexes from a type I reaction. Intracavital pulmonary aspergillosis involves mycotic development within a cavity or a complicating parenchymatous lesion. Severe hemoptysis may occur. Medical treatment is ineffective, and radical surgery is necessary in patients able to support operative procedures, which vary as a function of the condition of the patient. Diffuse aspergillosis occurs in immunodeficient patients, usually during the acute phase of chemotherapy induction. Spread of the disease is either from the upper respiratory tract or through the blood as septicemia. A nosocomial origin is frequent. Diagnosis depends more on the presence of hyphae in tissue biopsy specimens than cultures or serological tests which are too unreliable. Treatment is with amphotericin B preferably associated with 5 fluorocytosin.
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PMID:[Bronchopulmonary aspergillosis (author's transl)]. 708 69

A 2-year-old girl presented with a large right middle lobe cavitating lesion, complicated by life-threatening hemoptysis secondary to hyperimmunoglobulinemia E (hyper IgE) syndrome (Job's syndrome). This proved to be a bronchial artery pseudoaneurysm which was successfully embolized.
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PMID:Bronchial artery aneurysm in hyperimmunoglobulinemia E syndrome. 772 85

Systemic or topical treatment with antifungal agents are applied for the treatment of chronic pulmonary aspergillosis (fungus ball type, mural thickness type). Recently, the concomitant treatment with elastase inhibitor has been studied for the purpose of relieving tissue destruction by inhibiting elastase derived from aspergillus species. In the present study, we have examined the clinical effect of the topical treatment with Amphotericin B in patients with chronic pulmonary aspergillosis, and the concomitant use of Ulinastatin has also been examined in patients with symptoms such as hemosputum and hemoptysis. Amphotericin B was administered by transcatheter intracavity injection or transbronchial intrapulmonary injection. In some patients, inhalation was concomitantly employed. Amphotericin B was challenged by inhalation before starting the topical treatment, and if the patient experienced an asthma like attack, the present therapies were not conducted. Ulinastatin was administered by intravenous drip infusion concomitantly with antifungal agents and hemostatics. As a result, improvements regarding antifungal effects and clinical symptoms were found in 12 out of 15 patients treated with Amphotericin B. Further, early disappearance of hemosputum and hemoptysis was seen in 11 out of 23 episodes in 14 patients concomitantly treated with Ulinastatin. The treatment-related side effects, leading to discontinuation of those therapies, did not occur. Immunoresponse of allergy was studied in the patients ineligible for Amphotericin B topical treatment and the non-responders to Ulinastatin, and aspergillus specific IgE antibodies in serum were increased in the majority of patients. From the above results, it is desirable to carry out the topical treatment in chronic pulmonary aspergillosis. Also, it was considered valuable to apply the concomitant treatment with Ulinastatin, elastase inhibitor, to patients with severe clinical symptoms of hemosputum and hemoptysis.
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PMID:[Treatment of chronic pulmonary aspergillosis (fungus ball type, mural thickness type)]. 907 Oct 95


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