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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The value of differential cell counts in bronchoalveolar lavage fluid in patients who were serologically positive for the human immunodeficiency virus (HIV) was studied in 30 patients with classified into four groups according to the severity of illness: (1) seven subjects with the AIDS related complex without clinical or radiological evidence of pulmonary infection; (2) eight patients with the AIDS related complex and pulmonary tuberculosis; (3) eight patients with AIDS and Pneumocystis carinii pneumonia; and (4) seven patients with AIDS, Pneumocystis carinii pneumonia, and severe respiratory failure. All four groups had a similar percentage of lymphocytes, significantly higher than that of a control group of 15 healthy volunteers. A significant increase in the percentage of neutrophils was observed in groups 2, 3, and 4. The lavage fluid differential cell count does not therefore appear to help in the differential diagnosis of pulmonary infections in HIV positive patients. The abnormal percentage of lymphocytes observed in some patients with the AIDS related complex without clinical evidence of pulmonary infection suggests that lung injury may exist before clinical or radiological abnormalities develop. This might be related to an immunological mechanism or might be caused by an undetected subclinical infection.
Thorax 1989 Apr
PMID:Bronchoalveolar lavage cell analysis in patients with human immunodeficiency virus related diseases. 278 19

An empirical approach to treating Pneumocystis carinii pneumonia was adopted in a prospective study of 73 men with antibodies to human immunodeficiency virus 1 (HIV-1) presenting with respiratory problems. At presentation 49 patients (group 1) were thought to have a history, findings at clinical examination, chest radiograph, and arterial blood gas tensions typical of pneumocystis pneumonia, and empirical treatment was begun immediately. Twenty four patients (group 2) were thought to have features not typical of pneumocystis pneumonia. All patients were subsequently referred for bronchoscopy to determine the diagnosis. In group 1 four patients were excluded from the analysis because bronchoscopy was not possible. Of the remaining 45, 42 had pneumocystis pneumonia, which was diagnosed at bronchoscopy in 40, and on the basis of the clinical response to co-trimoxazole in two who had negative results from investigations. Of the three patients without pneumocystis pneumonia, one patient with lymphoid interstitial pneumonitis and Branhamella catarrhalis infection would have failed to respond to empirical treatment. The other two had multiple bacterial pathogens at bronchoscopy; one already had Kaposi's sarcoma and the other would have been misdiagnosed as having AIDS. In group 2 a specific diagnosis was made at bronchoscopy in 21 cases, including pneumocystis pneumonia in seven (all had atypical chest radiographs). In three cases no diagnosis was made and spontaneous recovery occurred. Adopting an empirical approach to treatment for typical pneumocystis pneumonia (group 1) led to the correct treatment in 43 of 45 cases (95%) and would have saved 44 of the 45 of bronchoscopies in this group. Adopting an empirical approach would have caused one patient to be misdiagnosed as having AIDS. Overall, 44 out of 69 bronchoscopies (64%) would have been saved; the specificity for the diagnosis of pneumocystis pneumonia was 85% and the sensitivity was 85%. Adopting an "empirical" treatment policy for typical pneumocystis pneumonia will cause a large reduction in the number of "high risk" bronchoscopies performed.
Thorax 1989 Jul
PMID:Empirical treatment without bronchoscopy for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. 278 35

Pulmonary function was measured in 169 male patients seropositive for the human immunodeficiency virus (HIV). The transfer factor for carbon monoxide (TLCO) in symptom free patients and patients with persistent generalised lymphadenopathy was normal (greater than 83% of predicted values). Patients with the AIDS related complex, non-pulmonary Kaposi sarcoma, and non-pulmonary non-Kaposi sarcoma AIDS (that is, opportunist infections affecting other organs) had lower mean values for TLCO (77%, 70%, and 70% of predicted respectively). These values were significantly lower than values for symptom free patients. Lower mean values of 50% and 63% predicted TLCO were observed in patients during the acute and recovery phases of Pneumocystis carinii pneumonia. TLCO was also low in patients with lung mycobacterial infection and in a patient with lung Kaposi sarcoma. Forced expiratory volume in one second, peak expiratory flow, and maximal expiratory flow at 50% of vital capacity were significantly reduced only in patients with acute pneumocystis pneumonia. This study shows that abnormalities in the results of pulmonary function tests, particularly TLCO, although greatest in patients with pulmonary complications of AIDS, are also present in patients with AIDS but without other evidence of pulmonary disease, and in patients with the AIDS related complex. The predictive and prognostic implications of these findings require further investigation.
Thorax 1988 Jun
PMID:Lung function abnormalities in patients infected with the human immunodeficiency virus with and without overt pneumonitis. 326 43

We analyze the cases of 215 adult patients affected from tuberculosis (TB) and infection due to human immunodeficiency virus (HIV) in the study period from December 6th, 1986 to January 31st of 1992. Disease affected specially the group of drug addict patients (DAP) with a 74.88%, followed by paid plasma donors (PPD) from our city with a 12.09%. Sexual transmission was the route of contamination with the HIV in 16 cases. In five cases atypical mycobacteria were detected. First-line anti-tuberculostatics drugs activity against Mycobacterium tuberculosis was excellent. A total of 17 cases with toxicity to any of these drugs were described. TB was located in the lung in 108 cases (50.23%), in 74 cases out of the lung (34.41%) and in 33 cases there was intrapulmonary as well as extrapulmonary affectation (15.34%). TB was diagnosed at the same time that a disease which met AIDS criteria in 13.49% of cases, TB was diagnosed first in 32.55% of cases, and AIDS was diagnosed before TB in only 7.91% of cases. Fever was the predominant symptom (88.84%), together with toxic status at admittance (80.47%) and deteriorated immune situation with lymphocytes count decrease (mean 1240/mm) and CD4 (mean value 134.5/mm) together with a mean raised IgA (492.85 mg/dl). Thorax radiography was normal in 34.88%. In 33 of these patients TB was localized in the lung, in 27.91% primary radiologic types were observed while in 31.16% reactivation types. In 51 cases (23.72%) tuberculosis was detected in patients (DAP) who were forwarded from the penitentiary system.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Tuberculosis and human immunodeficiency virus infection. A prospective study of 215 patients]. 849 37

A case of pulmonary sarcoidosis and idiopathic CD4+ T lymphocytopenia is reported. Pneumocystis carinii was detected in the bronchoalveolar lavage fluid of a young homosexual man who was asymptomatic without any evidence of congenital or acquired immunodeficiency but with a low CD4+ cell count. A clinical and histological diagnosis of pulmonary sarcoidosis was made. During follow up the patient had oral candidiasis and a CD4+ cell count persistently below 300/microliters. This case is highly suggestive of concurrent pulmonary sarcoidosis and idiopathic CD4+ T lymphocytopenia.
Thorax 1996 Apr
PMID:Pneumocystis carinii in a patient with pulmonary sarcoidosis and idiopathic CD4+ T lymphocytopenia. 873 4

The case history is presented of a patient with common variable immunodeficiency in whom heart lung transplantation has been carried out with success. Transplantation was the only long term therapeutic option in this patient due to the progressive respiratory failure resulting from bronchiectasis, emphysema, and granulomatous lung disease.
Thorax 1998 Jul
PMID:Heart lung transplantation in a patient with end stage lung disease due to common variable immunodeficiency. 979 64

Lymphocytic interstitial pneumonia (LIP) is a rare form of interstitial lung disease. A few case reports have described an association with common variable immunodeficiency (CVID). Corticosteroids are usually used to treat symptomatic patients but their efficacy has never been studied in a controlled trial. We describe a patient with LIP and CVID who was treated monthly with intravenous immunoglobulins (IVIG) without steroids. The patient improved dramatically. We believe that, in selected cases of LIP and immunodeficiency, IVIG given monthly should be considered as the only treatment without adding steroids.
Thorax 2006 Dec
PMID:Lymphocytic interstitial pneumonia associated with common variable immunodeficiency resolved with intravenous immunoglobulins. 1711 73

Chronic lung diseases are increasingly recognised complications of the human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). Of these, pulmonary emphysema, characterised by permanent destruction of the lung parenchyma distal to the terminal bronchioles accompanied by various degrees of inflammation, is emerging as a distinct source of morbidity for patients infected with HIV. Similarly, HIV is now frequently cited as a susceptibility factor for the development of emphysema, independent of cigarette smoking status. The presence of common coexistent confounding factors that may predispose patients to chronic lung injury such as drugs, opportunistic infections and malnutrition, limits the scope of studies of direct mechanisms involved in HIV associated emphysematous lung disease. We review the clinical studies supporting a direct association between HIV infection and emphysema. Recent developments in the basic understanding of HIV infection and emphysema are also reviewed, since they may aid in understanding the pathobiology of HIV associated emphysema. The authors emphasise how HIV infection may affect cytotoxic lymphocyte activation, lung capillary endothelial cell injury and apoptosis, sphingolipid imbalance and oxidative stress in the lung. A better understanding of the pathogenesis of HIV associated pulmonary emphysema may provide clues and therapeutic targets that have broader application in this disease, including cigarette smoke induced emphysema.
Thorax 2008 May
PMID:HIV associated pulmonary emphysema: a review of the literature and inquiry into its mechanism. 1844 63

We report the simultaneous occurrence of lymphocytic interstitial pneumonitis and pulmonary embolism in a patient with tetralogy of Fallot and common variable immunodeficiency. An explanation based on the pathogenesis of these diseases is proposed to explain this "unfortunate coincidence".
Thorax 2008 May
PMID:Lymphocytic interstitial pneumonia and pulmonary embolism in a patient with tetralogy of Fallot and common variable immunodeficiency: is there any link? 1844 64

THE causes of Cushing's syndrome are mainly divided into adrenocorticotropic hormone (ACTH) dependent and independent. ACTH dependent hypercortisolism represents excess ACTH se-creting by the pituitary or tumor outside the pituitary; and the latter one is also called as ectopic ACTH syndrome. Thorax is the most common location of causative lesions for ectopic ACTH syndrome, and the size of lesion is too small to be detected in some cases.1, 2 Cryptococcal pneumonia usually occurs in immunocompromised patients and excess cortisol production can theoretically produce a state of immunodeficiency. Development of cryptococcal pneumonia concomitant with Cushing syndrome (CS) was rare. Here, we report a case of pulmonary nodule in a patient with CS differentiated with ectopic ACTH-producing tumor. Cryptococcal pneumonia was diagnosed following lung resection.
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PMID:A Small Solitary Pulmonary Nodule Discovered by (18)F-fluorodeoxyglucose Positron Emission Tomography and CT: Rare Infection Instead of Rare Tumor. 2329 92


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