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)

An occupational interstitial pulmonary disease was observed in a 59-year-old workman after five years of massive exposure to aerosolized paraffin. Histologic studies of open-lung biopsy showed a lipoid pneumonia characterized by (1) alveolitis involving large lipid-laden macrophages and (2) interstitial fibrosis. Electron microscopy of AMs disclosed features of paraffin-laden cytoplasmic vacuoles. Successive treatments included prednisolone and cyclophosphamide. Despite these treatments and withdrawal from exposure, the pulmonary function became impaired progressively, resulting in restrictive syndrome and severe exertional dyspnea. Concomitantly, PMNs harvested by BAL increased, whereas initial lymphocytosis decreased. This is the first case observed of occupational interstitial fibrosis in which electron-microscopic findings clearly established a relationship with an exposure to paraffin. This observation also emphasizes the switch from alveolitis to fibrosis in the pathogenesis of interstitial pulmonary disease.
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PMID:Interstitial pulmonary disease induced by occupational exposure to paraffin. 229 45

About 20 cases of beta blocker-associated pneumonitis have been published in the mid-70s, and a case of interstitial pneumonitis has been attributed to propranolol. The pathogenesis of these cases of pneumonitis with or without pleural effusion is not clear. A 59-year-old man developed pneumonitis which showed all the characteristics of a drug-associated pneumonitis due to propranolol: BAL demonstrated a lymphocytosis, the variations of which closely correlated with a provocation test. The LIF appeared to be released by the patient's peripheral blood lymphocytes when cultured with optimal doses of propranolol. Production of LIF by the patients' lymphocytes suggests the existence of a drug-specific cellular immune response in propranolol-associated pneumonitis.
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PMID:Leukocyte migration inhibition in propranolol-induced pneumonitis. Evidence for an immunologic cell-mediated mechanism. 229 47

A 79-year-old man was given a cumulative dose of 16.5 g of nilutamide for treatment of prostate cancer. He then presented with a respiratory illness having clinical, radiologic and functional characteristics of interstitial pneumonitis. No other cause of pneumonitis was found. Bronchoalveolar lavage showed a lymphocytic alveolitis with an inverted lymphocyte subset ratio. After an 11-week period of drug withdrawal, clinical, radiologic and functional improvement was observed along with a normal alveolar lymphocytosis. Nilutamide therapy was then resumed for five weeks and induced the recurrence of clinical, functional and alveolar abnormalities. Nilutamide treatment was finally stopped and two months later, clinical and functional abnormalities resolved. This observation seems to exemplify the possible diagnostic value of coupling provocation test with BAL cell data in hypersensitivity pneumonitis induced by drugs. In addition, these data support the role of a cell-mediated immunologic mechanism in the pathogenesis of nilutamide-induced pneumonitis.
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PMID:Provocation test coupled with bronchoalveolar lavage in diagnosis of drug (nilutamide)-induced hypersensitivity pneumonitis. 229 82

In 18 renal transplant patients with pneumonia under ciclosporin therapy the diagnostic value of BAL and of covered micro brush smears were compared. In 10 out of 18 cases partly atypical bacterial pathogens were cultivated and cytomegaly was diagnosed 4 times, mycosis twice, whereas 2 cases could not be clarified. A granulocytosis in the differential cell pattern correlated with a bacterial infection.
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PMID:[The diagnostic value of bronchoalveolar lavage in opportunistic pneumonia following kidney transplantation]. 236 3

Pneumonitis has been reported to be a rare complication of low-dose MTX treatment. This paper describes a 62-year-old male patient in whom clinically successful low-dose treatment was applied. After six months of treatment, a gradually progressive pulmonary symptomatology developed and abruptly deteriorated. Radiological examination revealed interstitial and intra-alveolar densifications; functional analysis revealed partial respiratory failure. The histological finding of interstitial lymphocytic infiltration with giant cells and a chronic intra-alveolar pneumonia, with bacteriological detection of E. coli and Proteus vulg. in the BAL fluid, confirmed the suspected diagnosis of primary MTX-induced pneumonitis with secondary bacterial superinfection. In view of the fact that the literature does not seem to contain unequivocal definition, it is urgently recommended that unequivocal criteria be established.
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PMID:[Pneumonitis as a complication of low-dose methotrexate therapy in chronic polyarthritis]. 236 74

Identification of Pneumocystis carinii involves silver stains which require several hours for processing. Diff Quik, a differential stain similar to Wright-Giemsa, requires less than 1 min and reproducibly stains trophozoites and intracystic bodies of P carinii. To determine the utility of DQ for rapid detection of P carinii in BAL fluid, we reviewed DQ-stained slides of 50 BAL samples from 36 patients seropositive for HIV+ who had undergone bronchoscopy with BAL for evaluation of interstitial pulmonary infiltrates. A comparison group of immunocompromised patients with P carinii pneumonia also were reviewed. For HIV+ samples, sensitivity of DQ was 93 and 100 percent for cytopathologists and 75 and 89 percent for pulmonologists. Specificity was 95 percent for each cytopathologist and 100 percent for pulmonologists. For non-HIV+ patients, sensitivity ranged from 22 to 55 percent. Thus, DQ may be useful as a rapid, reliable method to identify P carinii in BAL fluid from HIV+ patients.
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PMID:Use of a rapid differential stain for identifying Pneumocystis carinii in bronchoalveolar lavage fluid. Diagnostic efficacy in patients with AIDS. 246 72

In this study, IgE-Fc receptor expressions on each type of BAL cells (lymphocytes, macrophages and eosinophils) in a patients with eosinophilic pneumonia accompanied by bronchial asthma were examined by indirect immunofluorescent method using monoclonal antibody (H107). BAL cell findings showed marked increases of total BAL cell counts and eosinophils, an increased number of lymphocytes and the presence of basophilic cells. These results match those of our previous report. Furthermore, IgE-Fc receptor expressions on lymphocytes, macrophages and eosinophils were markedly increased as compared to those in the peripheral blood and normal control subjects. These findings suggest that IgE production in the lung plays the main role in the pathogenesis of eosinophilic pneumonia and bronchial asthma. On the other hand, during ketotifen administration, decreases of peripheral blood eosinophilia, of eosinophilia in the sputum and of serum IgE level and an improvement in chest X-ray findings were observed. Furthermore not only normalization of total BAL cell counts but also decreases of IgE-Fc receptor expressions on BAL cells were observed.
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PMID:[IgE-Fc receptor expressions on bronchoalveolar lavage (BAL) cells in a patient with eosinophilic pneumonia accompanied with bronchial asthma--the effect of ketotifen on their expression]. 252 47

We compared nonbronchoscopic bronchoalveolar lavage (NB-BAL) with open lung biopsy to determine the etiological diagnosis of lung infiltrates in patients requiring mechanical ventilation. NB-BAL was performed via a cuffed reusable 7F catheter generally used for right heart catheterization (BAL-C). In 13 patients, BAL-C and open lung biopsy were performed in the same lobe immediately after death when the ventilator was still functioning. No organism was cultured from BAL-C cultures when histopathologic examination of the lung showed no pneumonia and lung culture isolated no organism. Among the 10 positive BAL-C cultures, lung biopsy showed histologic pneumonia in 9 cases. Among these 9 pneumonia cases, 14 organisms were isolated in lung cultures and BAL-C correctly identified the causative agent in 13 cases. BAL-C appears to be an effective and safe procedure in the diagnosis of pulmonary infections in patients under mechanical ventilation who have previously received antibiotic therapy.
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PMID:Comparison of nonbronchoscopic bronchoalveolar lavage to open lung biopsy for the bacteriologic diagnosis of pulmonary infections in mechanically ventilated patients. 271 13

Bronchiolitis obliterans organizing pneumonia (BOOP) is a pathologic finding common to various injuries to the lung of either definite or idiopathic etiology. Since the presentation of patients with idiopathic BOOP varies, we studied 16 patients with BOOP on pulmonary histology to define more distinct and homogeneous clinical and imaging profiles of idiopathic BOOP. We distinguished three groups of patients: group 1 (n = 4), with multiple patchy migratory pulmonary involvement of the pneumonia type. Their clinical course was subacute, with cough, fever, weight loss, mild dyspnea, and increased ESR. Chest x-ray film and CT scan showed multiple alveolar opacities. All patients completely recovered with corticosteroid therapy but relapsed when therapy was stopped too rapidly. Group 2 (n = 5) had solitary pulmonary involvement of the pneumonia type occurring in a similar clinical context. Since carcinoma was suspected, they underwent surgical excision of the pneumonic area and recovered without relapse. Group 3 patients (n = 7) presented with diffuse pulmonary involvement of the interstitial lung disease type. They had more progressive onset of more severe dyspnea, crackles heard over all lung surfaces, and interstitial opacities with or without alveolar opacities on chest imaging. Improvement with corticosteroid therapy was obtained in only three patients. In all three groups, lung function test results showed a restrictive pattern. The obstructive pattern characteristic of pure bronchiolitis obliterans was found in none. BAL showed a mixed pattern (increase of both lymphocytes and polymorphonuclear cells) in the patients of the first two groups. Thus, we distinguished three characteristic clinical and imaging profiles in patients with idiopathic BOOP: multiple patchy pneumonia, solitary pneumonia, and diffuse interstitial lung disease. These profiles are so different that they should be distinguished in clinical studies of idiopathic BOOP.
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PMID:Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients. 280 73

Fifteen 67Ga lung scans were obtained from 11 men with AIDS to detect opportunistic lung infection. Results were compared with clinical findings, chest radiographs, CO-transfer and transbronchial biopsies or BAL. Clinical symptoms were least helpful in diagnosing pneumonia. Chest radiographs were normal in six of eight normal 67Ga studies and abnormal in four of seven abnormal scans. In four cases the X-ray showed equivocal abnormalities, twice corresponding to a normal and twice to an abnormal scan. Once the X-ray was normal, but the scan showed diffuse abnormalities. CO-transfer in patients with a normal scan was higher (55-68%) than in patients with an abnormal scan (22-44%). Biopsy or BAL revealed P. carinii in five of six patients. Cytomegalo-virus was isolated once. All six patients had abnormal 67Ga scans. 67Ga lung scintigraphy is a sensitive indicator of active lung disease in AIDS, especially when chest X-rays are normal or equivocal.
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PMID:Gallium-67 lung scintigraphy in patients with acquired immune deficiency syndrome (AIDS). 301 49


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