Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085383 (hypocapnia)
 1,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective clinico-pathological analysis of 78 cases of fatal subarachnoid hemorrhage (SAH) was carried out: 71% had a pathological diagnosis of pulmonary edema (PE), and of these 31% had a clinical diagnosis of PE. Patients with pathological PE were younger and died sooner after their SAH than those without. The incidence of PE fell with the passage of time following SAH, while the occurrence of pneumonia and embolism increased. There were hypoxemia and hypocapnia in both groups, more severe in the group that had pathological PE. The pathophysiology of neurogenic PE is discussed and possible therapeutic approaches indicated.
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PMID:Pulmonary edema following fatal aneurysm rupture. 69 Jun 77

Methotrexate, an antifolate cytotoxic drug, is used in anticancer chemotherapy as well as an immuno suppressive in rheumatoid arthritis. It is responsible for numerous secondary effects, amongst which is a characteristic acute pneumonia known since 1969. This pneumonitis has been described in detail, up to the present time in 78 cases gathered in this review. The prevalence of this complication is estimated at around 7%. This pneumonia may occur whatever the age, indication for which methotrexate is prescribed, the route of administration of the product (including the intra-thecal route) and the dose. It includes dyspnoea, fever, (sometimes quite marked) and frequently an acute reversible respiratory failure. Radiologically the opacities are usually diffuse interstitial and symmetrical with a basal predominance with sometimes some confluence and occasionally a pleural reaction. In a small number of cases a transient mediastinal adenopathy has been described. Respiratory function tests show a rapidly developing restrictive syndrome accompanied by hypoxia and hypocapnia. Broncho-alveolar lavage is characterised by hypercellularity with a frank and apparently transitory lymphocytosis. Histologically the most frequent lesion sighted is an extensive acute granulomatous reaction with or without oedema. Most often the outcome is favourable (75% of cases). However 6 deaths due to respiratory failure have been reported. Even though there has not been any formal test, steroid therapy in high dosage seems to accelerate recovery. Progress to an irreversible pulmonary fibrosis is possible but rare. The mechanism of this drug related acute pneumonia is not known but would seem to resemble that of other granulomatosis. Besides this rapidly progressive pneumonitis, methotrexate is responsible for a very small number of cases of severe pulmonary oedema and of acute painful pleurisies.
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PMID:[Pneumopathy caused by methotrexate]. 225 35

Six children who remained in deep coma after immersion accidents in fresh water received therapy to maintain normal intracranial pressure (ICP). This involved controlled ventilation to ensure hypocapnia and hyperoxaemia, maintenance of low normothermia, fluid restriction, dexamethasone (1-1.5 mg/kg initially, 1-1.5 mg/kg/day as maintenance) and barbiturates (phenobarbitone and thiopentone). The latter were given in a wide range of dosage. Increased ICP was common to all patients, but could always be kept at acceptable levels. All patients suffered from pulmonary oedema; three developed broncho-pneumonia and two developed adult respiratory distress syndrome. All children survived with good recovery, two needed active rehabilitation for several months.
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PMID:Intensive care after fresh water immersion accidents in children. 718 Oct 62

BACKGROUND: The aim of this retrospective study was to determine the clinical, laboratory, and radiological features of all adult patients with varicella-zoster virus pneumonia (VZVP) treated in our departments during the last 5 years. Important therapeutic and evolutionary features are also reported. METHODS: Fourteen patients (11 males and 3 females, mean age OF 36.4 and 34.3 years, respectively), diagnosed as suffering from VZVP, were included in this study. The antecedents of previous contact with patients with varicella, smoking, pregnancy, and underlying diseases were evaluated. In all cases, the diagnosis of pneumonia was established by clinical and radiological criteria in the course of varicella infection. RESULTS: All but one patient had had previous contact with a varicella patient. Eleven of them (78.57%) were smokers. None of the patients was immunocompromised. All patients had the characteristic rash of the disease, fever, and cough. Only six (43%) had bilateral sparse rales on auscultation. Arterial blood gas analysis at the onset of VZVP revealed hypoxemia in seven patients (50%) and hypocapnia in six (43%). Mean PaO(2) was 55 mmHg (range of 42-68 mmHg) and mean PaCO(2) was 34 mmHg (range of 27-36 mmHg). Chest radiographs showed ill-defined nodular or reticular densities of various sizes scattered throughout both lung fields. A CT scan of the chest, performed in seven patients (50%), confirmed the radiological findings and marked out patchy ground-glass attenuation in three patients and coalescence of lesions in two others. After diagnosis, all patients were immediately started on acyclovir 5-10 mg/kg every 8 h. Five patients (36%) were admitted to the ICU due to acute hypoxemic respiratory failure. Two patients received noninvasive positive pressure ventilation via a facemask and the other three patients with a clinical diagnosis of ARDS were intubated and ventilated mechanically. The duration of patient hospitalization was 16+/-10 days. One patient (8%) died in the ICU on the third day after admission due to multiple organ dysfunction (MOF). All of the other patients recovered completely without any sequelae. CONCLUSIONS: Adult patients with severe VZVP must be admitted and treated in the ICU. The use of intravenous acyclovir may be lifesaving, preventing progressive respiratory failure and reducing the high mortality rate of the disease.
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PMID:Varicella-zoster virus pneumonia in adults: report of 14 cases and review of the literature. 1552 70

An active duty male presented to the emergency room with dyspnea for 2 days after undergoing liposuction surgery. Upon presentation, the patient was afebrile, tachycardic, tachypneic, and hypoxemic. The initial chest radiograph demonstrated bilateral patchy opacities and the PaO2/FiO2 ratio was <200. The patient was admitted to the medical intensive care unit for supportive care. He was treated empirically for pneumonia. Blood and sputum cultures were negative. A computed tomography angiogram of the chest was negative for pulmonary embolism but did reveal a bilateral, perihilar air space process. The patient's oxygen requirement improved and the abnormal chest radiographic findings resolved over the next 48 hours. Given his clinical presentation, negative workup, and rapid recovery, the patient was given a presumptive diagnosis of pulmonary fat embolism. Fat embolism occurs when adipocytes and small blood vessels are damaged during the liposuction procedure. Patients may present with low-grade fever, tachycardia, tachypnea, hypoxemia, and hypocapnia. The differential diagnosis includes venous thromboembolism, aspiration pneumonitis, and pneumonia. The mainstay of treatment for pulmonary fat embolism is supportive care. The risk of mortality is 5 to 15%.
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PMID:Acute respiratory distress following liposuction. 1761 55

This report presents the case of a 67-year-old woman affected by glioblastoma. After a few days of adjuvant therapy with temozolomide and prophylaxis with trimetrophin-sulfamethoxazolo to prevent Pneumocystis Jiroveci, she had progressive and rapid worsening of symptoms with weakness, dyspnea and orthopnea. She had peripheral edema and proximal hyposthenia of the lower limbs. Chest CT showed bilateral ground-glass opacities and laboratory exams revealed hypoxemia and hypocapnia, an initial reduction in platelet and white blood cells, and an elevation of LDH, AST, ALT, and active urinary sediment. Blood cultures, bronchoalveolar lavage (BAL) data and transbronchial biopsy showed no infections, and in particular no evidence of Pneumocystis Jiroveci pneumonia. Histological examination revealed a typical pattern of AIP. She was treated with broad-spectrum antibiotics and high-dose steroids. The symptoms worsened and respiratory failure required mechanical ventilation. The pneumonia was not responsive to medical or invasive care. She died after ten days of hospitalization. At present very little can be found in the literature about lung toxicity caused by temozolomide. This case can be added as a new report describing this risk. The combination therapy with temozolamide and trimetophin-sulfamethoxazolo could have a synergistic action inducing various forms of pulmonary toxicity. ESTABLISHED FACTS: Acute interstitial pneumonia is a common manifestation of lung toxicity caused by drugs. The clinical course is favorable with a good response to corticosteroids. NOVEL INSIGHT: This is the first fatal case of lung toxicity caused by Temozolomide. Clinicians must be aware that a combination therapy including trimetophin-sulfamethoxazolo could have a synergistic action in inducing pulmonary toxicity.
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PMID:A fatal case of acute interstitial pneumonia (AIP) in a woman affected by glioblastoma. 2441 Mar 8