Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pathological findings in the lungs and related organs of 26 patients (21 female, 5 male) with systemic lupus erythematosus (SLE), with onset of disease before age 20 years, were reviewed. Several categories of lung lesions were found. Chronic interstitial pneumonitis was present in all 26 patients and was severe in 5. Acute pneumonia was present in 20, mild in 13, moderate in 2, and severe in 5. Alveolar hemorrhage, massive enough to cause death in 5, was seen in 18 patients, and pulmonary edema was found in 13. Fourteen patients had hyaline membranes indicative of acute alveolar damage (DAD), 12 had alveolitis obliterans, indicative of prior episodes of DAD, and 9 had bronchiolitis obliterans. Other parenchymal lesions were mild interstitial fibrosis in 12, alveolar hemosiderosis and alveolar overinflation in 10 each, and alveolar septal calcinosis with chronic renal insufficiency in 3. Pleural effusion, pleuritis, or pleural thickening were noted in 15 of 26, 6 of 23, and 7 of 23 evaluable patients, respectively. Vascular lesions were present in 16 as intimal thickening (9), thromboemboli (8), medial hypertrophy (6), calcinosis (3), and vasculitis (2). A previously unreported lesion was chronic (proliferative) peribronchitis, noted in 11 patients. Diaphragmatic lesions included mild variation in fiber size in 7, mild fibrosis in 2, and calcinosis in 1 of 13 evaluable patients. Correlation of the above lesions with previously described lung syndromes in SLE such as lupus pneumonitis, hemorrhagic lung disease, chronic interstitial fibrosis, lupus cor pulmonale, pleurisy, and "shrinking lung syndrome" are discussed.
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PMID:Pulmonary lesions in childhood onset systemic lupus erythematosus: analysis of 26 cases, and summary of literature. 360 12

Among the indications for renal artery revascularization, either surgical or endovascular, in patients with renal artery stenosis are poorly controlled hypertension, ischemic nephropathy (preservation of renal function), or recurrent episodes of "flash" pulmonary edema and congestive heart failure. Pharmacologic treatment is the first-line therapy to control blood pressure. If the disease is unilateral, the blood pressure regimen should include an angiotensin-converting enzyme inhibitor. Guidelines published in the Sixth Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of high blood pressure should be followed. Revascularization is recommended if patients have at least 75% stenosis of one or both renal arteries, combined with resistant or poorly controlled hypertension; recurrent flash pulmonary edema; dialysis-dependent renal failure resulting from renal artery stenosis; chronic renal insufficiency and bilateral renal artery stenosis; or renal artery stenosis to a solitary functioning kidney. To treat fibromuscular disease of the renal arteries, percutaneous transluminal angioplasty is the revascularization procedure of choice. Ex vivo surgical repair of the renal artery may be required if there is significant branch renal artery stenosis. To treat atherosclerotic renal artery stenosis, the revascularization procedure of choice is percutaneous transluminal angioplasty and stent implantation, especially if there is concomitant ostial or proximal renal artery disease. Surgical revascularization is performed if concomitant aortic surgery is required, such as for abdominal aortic aneurysm.
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PMID:Renal Artery Stenosis. 1109 69

We report the case of a 70-year-old hypertensive man with a solitary kidney and chronic renal insufficiency who developed two episodes of transient anuria after losartan administration. He was hospitalized for a myocardial infarction with pulmonary edema, treated with high-dose diuretics. Due to severe systolic dysfunction losartan was prescribed. Surprisingly, the first dose of 50 mg of losartan resulted in a sudden anuria, which lasted eight hours despite high-dose furosemide and amine infusion. One week later, by mistake, losartan was prescribed again and after the second dose of 50 mg, the patient developed a second episode of transient anuria lasting 10 hours. During these two episodes, his blood pressure diminished but no severe hypotension was noted. Ultimately, an arteriography showed a 70-80% renal artery stenosis. In this patient, renal artery stenosis combined with heart failure and diuretic therapy certainly resulted in a strong activation of the renin-angiotensin system (RAS). Under such conditions, angiotensin II receptor blockade by losartan probably induced a critical fall in glomerular filtration pressure. This case report highlights the fact that the angiotensin II receptor antagonist losartan can cause serious unexpected complications in patients with renovascular disease and should be used with extreme caution in this setting.
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PMID:Repeated transient anuria following losartan administration in a patient with a solitary kidney. 1125 25

Atherosclerotic renal artery stenosis (RAS) is the most common secondary cause of hypertension, and often results in hypertension that is difficult to control. Atherosclerotic RAS may also result in chronic renal insufficiency, and although controversial, likely leads to end-stage renal failure in a subset of patients. Bilateral RAS, or stenosis to a solitary functioning kidney, has resulted in recurrent episodes of "flash" pulmonary edema and unstable angina pectoris. Despite these serious sequelae of RAS, there remains no consensus on optimal therapy. Invasive therapy (endovascular percutaneous transluminal angioplasty, with or without stent deployment; surgical revascularization) has generated significant interest among interventional physician specialists. However, effective antihypertensive therapy may be a reasonable option in certain scenarios.
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PMID:Management of Atherosclerotic Renal Artery Stenosis: Interventional Versus Medical Therapy. 1132 12

Acidobasic balance and respiratory pulmonary functions were examined in 15 patients with chronic renal insufficiency during continuous ambulatory peritoneal dialysis (CAPD) using a dialysis solution containing 1.5% or 2.5% of glucose. Patients did not suffer from any pulmonary disease nor ischemic heart disease. Biochemical indicators of acidobasic balance were in reference range or on its lower margin. Respiratory pulmonary functions were in tolerance except maximum expiratory flow volume at 50% and 25% of vital capacity (MEF50 and MEF25) and except diffusion lung capacity (DLCO) which were decreased. Decrease of maximum expiratory flow could be caused by a loss of elasticity of pulmonary parenchyma and by a beginning increased resistance in peripheral pulmonary ways. Decreased DLCO was identified in majority of patients and was caused by anaemia and a minimal interstitial pulmonary edema. Use of a single peritoneal dialysis with dialysis solutions of various glucose concentrations did not have any significant effect on acidobasic balance markers nor pulmonary respiratory functions.
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PMID:[Continuous ambulatory peritoneal dialysis and respiratory pulmonary functions]. 1532 56

Hyponatremia is associated with adverse outcomes in patients with heart failure and ST-elevation myocardial infarction (STEMI). We evaluated the effect of hyponatremia on outcomes in patients with suspected acute coronary syndrome and non-STEMI. All patients had a sodium level determined at time of admission, at 24 and 48 hours, and at discharge. Of 1,478 patients, 341 (23.1%) were hyponatremic (sodium <135 mEq/L) on presentation. Patients who had hyponatremia on admission were significantly more likely to die or have recurrent myocardial infarction in the next 30 days (odds ratio 1.98, 95% confidence interval 1.35 to 2.89, p <0.001). This relation persisted after adjusting for factors such as age, left ventricular ejection fraction, use of diuretics before admission, hypotension on presentation, anemia, chronic renal insufficiency, pulmonary edema, and high troponin levels (odds ratio 1.7, 95% confidence interval 1.1 to 2.5, p = 0.01). In conclusion, hyponatremia on admission is associated with 30-day adverse outcome in patients presenting with suspected acute coronary syndrome/non-STEMI.
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PMID:Effect of hyponatremia (<135 mEq/L) on outcome in patients with non-ST-elevation acute coronary syndrome. 1765 18

Although patients undergoing acute hemodialysis (HD) constitute a group at risk for heparin-induced thrombocytopenia (HIT), the optimal therapeutic strategy remains undefined. We describe a case of HIT complicated with right subclavian vein thrombosis in a patient with chronic renal insufficiency undergoing acute HD for oligoanuria and pulmonary edema. Circulating anti-heparin-PF4 complex antibodies were detected. Past medical history was relevant for an otherwise unexplained self-limited episode of thrombocytopenia following acute HD one year earlier after an anterior STEMI. All sources of heparin were discontinued and alternative anticoagulation was initiated with argatroban, a direct-thrombin inhibitor with hepatic clearance, followed by transition to warfarin. Prevention of tunneled HD catheter obstruction was accomplished with low-dose alteplase catheter locking solution. No bleeding occurred with argatroban anticoagulation. Platelet count recovered and no further thrombotic complications were observed. The present report illustrates the diagnostic and therapeutic challenges of HIT complicating acute HD.
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PMID:Therapeutic implications of heparin-induced thrombocytopenia complicating acute hemodialysis. 2035 43