Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two middle-aged women showed typical erythematous heliotrope eruption and Gottron's sign without any symptom of myositis. The patients were diagnosed as 'amyopathic dermatomyositis' because of normal serum CPK levels, normal EMG and no histological abnormality by muscle biopsy. Clinical manifestations improved by the treatment with corticosteroids. During tapering of corticosteroids, however, intersititial pneumonitis developed and rapidly progressed. The first patients was treated with methylprednisolone pulse therapy, azathiopurine and methotrexate. The second patients was treated with betamethazone, methlprednisolone pulse therapy and cyclosporin A. In spite of these extensive immunosuppressive therapies, both patients died of pulmonary insufficiency a few months after admission. In the literature there has been only several cases of amyopathic dermatomyositis and only one case with fatal rapidly progressive interstitial pneumonitis. A new approach to the treatment of this disease should be made.
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PMID:[Two cases of amyopathic dermatomyositis with fatal rapidly progressive interstitial pneumonitis]. 224 55

In a 2-year-old boy with untreated cystic fibrosis, an acute deterioration of his chronic respiratory insufficiency developed due to bilateral pneumonia. This condition caused acute right-sided heart failure and nontransmural myocardial infarction of the inferior wall. In concordance with this diagnosis, a marked increase of CPK-MB levels combined with transient severe ischemia on the ECG and the absence of myocardial injury at echocardiography was seen. At 3 years follow-up, he was in good clinical condition.
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PMID:Nontransmural myocardial infarction as a complication of untreated cystic fibrosis. 232 73

Legionnaires' disease is primarily a respiratory disorder, but recently several cases with extrapulmonary manifestations are reported. We report a case of Legionnaires' disease associated with pneumonia, diarrhea, central nerve disorders and rhabdomyolysis. The pathogenesis of rhabdomyolysis in Legionnaires' disease remains speculative. Endotoxin isolated from Legionella pneumophila may play a role in the pathogenesis of the myonecrosis. An additional factor that might contribute to rhabdomyolysis in this case is severe dehydration induced by diarrhea. Pneumonia with elevated CPK levels and myoglobinuria may suggest Legionnaires' disease.
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PMID:[A case of Legionnaires' disease associated with rhabdomyolysis]. 250 24

A 18-year-old man was admitted with fever, dry cough, erythema, conjunctivitis, and dyspnea. The case was diagnosed as measles because of the typical clinical course and the increase of measles viral antibody titre. Electrocardiogram showed transient ST-T abnormalities and the laboratory data showed transient increase of CPK. Therefore myocarditis was considered. However chest roentgenogram showed no abnormal findings. Arterial oxygen was low. The Ga scintigram revealed diffused uptake in both lungs. Microscopic examination of the transbronchial lung biopsy revealed alveolitis. In view of he above, measles pneumonia was diagnosed in this case.
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PMID:[A case of measles in adolescents with myocarditis and pneumonia]. 250 6

A case in reported of the clinical syndrome of polymyositis in a young man. The syndrome masked pulmonary tuberculosis. Sudden appearance of pains and weakness of the muscles of the shoulder and abdominal muscles was accompanied by fever up to 40 degrees C, and macular rash on the trunk and extremities. During the disease right-sided pneumonia developed and regressed after treatment with antibiotics (tetracyclines, penicillin). Laboratory investigations showed high ESR, high leucocyte count, high levels of transaminases, CPK and LDH, and in cutaneo-muscular++ biopsy specimen scan subepidermal infiltrations were present. The patient was treated with corticosteroids with a striking improvement of the general condition. During this treatment left-sided pleural effusion developed. Bacteriological examination of the pleural fluid, including tests for acid-fast bacilli, was negative in direct examination, but these bacilli were cultured from fluid. No malignant cells were found. After antituberculous treatment the condition of the patient and the biochemical parameters became normal.
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PMID:[Polymyositis in pulmonary tuberculosis]. 262 70

Three cases of isolated right ventricular infarction resulting from thrombotic occlusion of a hypoplastic right coronary artery were found in 4,000 consecutive autopsies performed at Tokyo Metropolitan Geriatric Hospital. The incidence of isolated right ventricular infarction was 0.08%. The clinical profile of the first case was characterized by shock, pulmonary congestion, pleural effusion, decreased V1R and V2R on ECG, a small elevation of CPK and transaminase, elevation of fibrin degenerative products and decreased platelet count. The patient responded to volume expansion, heparin and catecholamines. One year later she died from cerebral bleeding. In the second case, mild aortic regurgitation and atrial fibrillation were present. He died suddenly during an episode of pneumonia. In the third case, there was chronic obstructive lung disease, atrial fibrillation and lung cancer. He died of respiratory failure. On autopsy, the coronary arteries revealed a marked left dominant and right hypoplastic pattern in all cases. The right coronary artery perfused only the free wall of the right ventricle. Complete occlusion of the hypoplastic right coronary artery resulted in isolated right ventricular infarction. In addition, chronic pulmonary disease and arrhythmia may be contributory.
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PMID:Isolated right ventricular infarction resulting from thrombotic occlusion of a hypoplastic right coronary artery. 272 33

Rheumatoid arthritis was diagnosed in a 48-year-old woman. She received a gold compound, and 4 weeks after the start of that therapy, interstitial pneumonia appeared. Findings from a muscle biopsy, and high serum CPK and LDH levels indicated that she suffered from polymyositis rather than rheumatoid arthritis. The result of a drug lymphocyte stimulation test (DLST) for the gold compound was more than 200%. Because the usefulness of the DLST for the gold compound in the diagnosis of gold pneumonitis is not thoroughly established, the DLST was also done in patients with rheumatoid arthritis who were receiving the gold compound without side effects, and in normal subjects. Many of the rheumatoid arthritis patients and some of the normal subjects had a positive response to the gold compound. Therefore a positive response on the DLST for the gold compound does not always support the diagnosis of gold pneumonitis.
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PMID:[A case of interstitial pneumonia in polymyositis difficult to distinguish from gold pneumonitis]. 756 1

Adenoviral pneumonia, while most common in infancy and young childhood, is rare in school childhood. Here, we report one case, a 13 years old otherwise healthy girl, suffered from fulminating pneumonia caused by adenovirus infection. She had dry cough, pharyngitis, lethargy, myalgia and fever in the beginning. Four days later, the patient became tachypneic, dyspneic and drowsy, and developed hypoxemia and diffuse bilateral infiltrates on chest radiographs. The laboratory data revealed elevated SGOT, CPK and LDH. Adenovirus was isolated from patient's endotracheal suction tube tips. Fortunately, weaning from mechanical ventilation was accomplished on the fifth day of hospitalization, despite of the high fatality rate of adenoviral pneumonia in this age group. The clinical characteristics and therapeutic management of our case are discussed and literatures reviewed.
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PMID:[Fulminating adenovirus pneumonia: report of one case]. 794 37

Based on the discussion of NMS, certain conclusions may be reached in regard to this patient. In the psychiatric setting, agitation and confusion alone are not suggestive of NMS. However in this patient, the symptoms of agitation, the rapid development of EPS symptoms unresponsive to anticholinergic therapy, autonomic changes (tachycardia, diaphoresis, and incontinence), and elevated CPK, met most of the diagnostic criteria described in Table VI. However, this case may have described an atypical presentation of NMS because of the absence of temperature increases during the onset of symptoms and the 7-week hospitalization for NMS. The patient's later onset of temperature elevations was a result of an aspiration pneumonia. Pneumonia and renal failure significantly increased the morbidity and extended the course of the illness. As a result, the diagnosis and specific treatment of NMS were delayed because of atypical symptoms and complications. In this patient, treatment of NMS with bromocriptine did not start until 10 days into hospitalization. A delay in pharmacologic therapy in this patient may have contributed to persistence of symptoms. The patient showed signs of improvement on day 21 during combination bromocriptine, benztropine, and dantrolene therapy. Moreover, this case exemplifies the rigorous need for supportive therapy and adjunctive pharmacologic therapy for primary and secondary complications resulting from NMS. In conclusion, because of the wide range of risk factors and variations of NMS, a systematic approach to diagnosing and treating NMS is critical to a successful outcome. Discontinuation of antipsychotics, maintenance of supportive therapy aimed at preventing dehydration, hemodynamic, and electrolyte imbalances, and pharmacotherapy are essential in the treatment of NMS.
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PMID:An atypical course of neuroleptic malignant syndrome. 800

Several cases of rhabdomyolysis associated with pneumococcal pneumonia have been recently reported. However their significance have been poorly investigated. In this retrospective study, we have compared the patients admitted in ICU for acute community-acquired pneumonia with or without rhabdomyolysis (group A: CPK > or = 1,000 Ul/l and group B: CPK < 1,000 Ul/l). Among the 41 patients of the study, 12 (29%) belonged to the group A (CPK = 1,852 +/- 535 Ul/l) and 29 (71%) to group B (CPK = 190 +/- 35 Ul/l). Neither the initial severity, nor renal impairment were different in the two groups. However the mortality was significantly higher in the group A (4/12) than in group B (2/29) (P < 0.05). In this study, pneumonia is frequently associated with rhabdomyolysis, without etiologic significance. In patients with pneumonia, rhabdomyolysis seems to be a bad prognostic indice unrelated with renal impairment.
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PMID:[Rhabdomyolysis in community-acquired pneumonia]. 805 43


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