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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The immunological basis of the inflammatory response in the lungs of patients with pneumonitis after bone marrow transplantation has been investigated by means of bronchoalveolar lavage. Ten episodes of pneumonitis associated with cytomegalovirus and nine episodes due to various other infectious and non-infectious causes were investigated in 16 patients (three patients had two episodes of pneumonitis). Total lavage cell counts and differential cell counts were determined and compared with results from normal control subjects. In most patients with pneumonitis the total cell yield was greater than normal (mean 6.8 (SD 6.0) x 10(5) cells/ml; normal 1-2 x 10(5) cells/ml). The percentage distribution of these cells was 71.9 (17) macrophage like cells, 24.1 (15.8) lymphocytes, 5.0 (5.0) polymorphonuclear cells, and 0.7 (1.0) eosinophils. None of the patients had peripheral lymphocytosis despite the increased number of lymphocytes in the lavage fluid. Further analysis of the lymphocyte population using monoclonal antibodies with immunocytochemical techniques showed that B cells were generally present in normal proportions, whereas the proportion of cells expressing T lymphocyte markers (CD2+, CD5+, CD8) were reduced in nine out of 19 cases. In 10 of the 19 episodes there were substantial numbers of cells expressing none of the B or T cell antigens studied ("null" cells). These abnormalities bore no relation to survival. The total cell yield, the proportion and number of lymphocytes, and the proportion and number of T cells in the bronchoalveolar lavage fluid were all lower in the group with cytomegalovirus infections than in those with pneumonitis from other causes. These results suggest that the pneumonitis in recipients of bone marrow transplants is associated with a local immune response despite the fact that the individuals are otherwise immunosuppressed.
Thorax 1989 Jul
PMID:Pulmonary cell populations in recipients of bone marrow transplants with interstitial pneumonitis. 267 6

Three pregnant patients with chickenpox pneumonia are described. A review of reports published since 1965 together with these cases shows that 28 of the 46 women (61%) were pregnant, and 21 were in the last trimester. Although the disease is more common and more severe in pregnancy, the proportion of deaths was no greater than usual. In this retrospective analysis there was no evidence that treatment with acyclovir conferred benefit but this may have reflected its use only in very ill patients.
Thorax 1989 Oct
PMID:Chickenpox pneumonia: an association with pregnancy. 233 May 58

A patient developed eosinophilic peripheral pulmonary infiltrates while receiving malaria prophylaxis with sulfadoxine-pyrimethamine (Fansidar). Withdrawal of Fansidar and treatment with corticosteroids led to rapid recovery. No exacerbation occurred after cessation of corticosteroids. Lymphocyte transformation testing gave a positive result in the presence of sulfadoxine but not pyrimethamine. It is concluded that drug hypersensitivity to sulfadoxine was the cause of the eosinophilic pneumonia in this patient.
Thorax 1989 Apr
PMID:Sulfadoxine specific lymphocyte transformation in a patient with eosinophilic pneumonia induced by sulfadoxine-pyrimethamine (Fansidar). 276 33

A woman with asthma developed chronic necrotising semi-invasive pneumonia due to mixed Aspergillus niger and Candida albicans infection; though not severely immunosuppressed, she may have been predisposed by long term oral corticosteroid and recurrent oral antibiotic treatment. The diagnosis should be considered in patients with chronic airflow limitation who develop cavitating pneumonia.
Thorax 1989 May
PMID:Chronic necrotising pneumonia caused by Aspergillus niger. 276 49

The diagnostic value of 73 bronchoalveolar lavages was assessed in 67 immunocompromised children (aged 3 months to 16 years) with pulmonary infiltrates. Thirty one children had primary and 19 secondary immune deficiency, 14 acquired immunodeficiency syndrome (AIDS), and three AIDS related complex. Bronchoalveolar lavage was performed during fibreoptic bronchoscopy, under local anaesthesia in all but two. One or more infective agents was found in eight of 11 patients with severe acute pneumonia and in 26 of 62 patients with interstitial pneumonitis. In interstitial pneumonitis, the most frequently encountered agents were Pneumocystis carinii (12), cytomegalovirus (8), and Aspergillus fumigatus (3). The yield was related to the severity of interstitial pneumonitis. The mean cellular count and cytological profile in lavage returns from patients with varying infective agents or underlying pathological conditions showed no significant difference, except in those children with AIDS and AIDS related complex who had appreciable lymphocytosis (mean percentage of lymphocytes 28 (SD 17]. In children with AIDS and chronic interstitial pneumonitis lymphocytosis without pneumocystis infection was observed in eight of nine bronchoalveolar lavage returns and was suggestive of pulmonary lymphoid hyperplasia. Finally, bronchoalveolar lavage produced a specific diagnosis from the microbiological or cytological findings in 44 instances (60%). Transient exacerbation of tachypnoea was observed in the most severely ill children but there was no case of respiratory decompensation attributable to the bronchoscopy. Bronchoalveolar lavage is a safe and rapid examination for the investigation of pulmonary infiltrates in immunocompromised children. It should be performed as a first line investigation and should reduce the use of open lung biopsy techniques.
Thorax 1987 Oct
PMID:Value of bronchoalveolar lavage in the management of severe acute pneumonia and interstitial pneumonitis in the immunocompromised child. 282 34

Forty episodes of pneumonitis in 30 recipients of allogeneic bone marrow transplants were investigated by fibreoptic bronchoscopy and bronchoalveolar lavage. A positive diagnosis was made in 32 episodes of pneumonitis (24 patients), giving a diagnostic yield of 80%. In 31 of these the diagnosis was made within 24 hours of bronchoscopy and this enabled the appropriate treatment to be instituted early. Eighteen patients recovered from their primary infection, although two died subsequently of respiratory failure due to postpneumonic lung destruction. Ten patients later developed a second episode of pneumonitis and a diagnosis was made in nine of these. Only three survived a second episode. Bronchoalveolar lavage was well tolerated by all patients and there was no morbidity or mortality that could be directly attributed to the procedure. Bronchoalveolar lavage is a safe and valuable early diagnostic procedure for the investigation of pulmonary complications in patients who have received bone marrow transplants.
Thorax 1987 Oct
PMID:Role of bronchoalveolar lavage in the evaluation of interstitial pneumonitis in recipients of bone marrow transplants. 282 35

The main clinical problems that follow heart-lung transplantation are opportunist infections of the lungs and pulmonary rejection. Of 23 patients undergoing heart-lung transplantation, eight had opportunist infections and 12 had at least one episode of pulmonary rejection. Cardiac rejection occurred in only one patient, who did not need treatment. Of the 12 patients who had pulmonary rejection, nine recovered fully after augmented immunosuppression with high dose corticosteroids, although one patient required additional low dose corticosteroids for eight months before making a full recovery. Fatal opportunist lung infection followed treatment for rejection in two patients. One patient developed obliterative bronchiolitis. Of the eight patients with opportunist infections, five had primary cytomegalovirus pneumonitis, acquired from the donor. All three patients treated with acyclovir died, whereas the two treated with hyperimmune globulin and dihydroxy proxymethylguanine recovered fully. Two patients developed Pneumocystis carinii pneumonia, which was treated successfully in one patient with intravenous sulphadimidine and trimethoprim. The other patient died after a further episode of rejection and aspergillus bronchitis. One patient developed a tuberculous empyema. The calculated actuarial survival at one year was 78% and at two years 67.2%. Although it is still in its innovative stage heart-lung transplantation appears to have complications and results similar to those of transplantation of other organs.
Thorax 1988 Oct
PMID:Clinical experience in the management of pulmonary opportunist infection and rejection in recipients of heart-lung transplants. 284 14

In 12 of 451 patients diagnosed as having pneumonia in a single hospital over 18 months the causative organism appeared to be Branhamella catarrhalis.
Thorax 1988 Nov
PMID:Pneumonia due to Branhamella catarrhalis. 314 19

Of 13 patients with chickenpox pneumonia (12 of them adults) treated during 1979-87, 10 received antiviral drugs--nine acyclovir and one vidarabine. Three died despite intensive treatment. Serious secondary infections occurred in six cases. There were no clear indications that antiviral treatment altered the natural history of the condition. Acyclovir may at present be used too late in the course of chickenpox pneumonia to alter its outcome.
Thorax 1988 Aug
PMID:Chickenpox pneumonia: experience with antiviral treatment. 317 75

A young woman with ulcerative colitis developed pneumonia, which responded to corticosteroids. Histological examination showed this to be bronchiolitis obliterans organising pneumonia.
Thorax 1988 Sep
PMID:Bronchiolitis obliterans organising pneumonia in a patient with ulcerative colitis. 319 83


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