Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0206061 (interstitial pneumonia)
 6,105 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Considerable progress has been made in the prophylaxis and treatment of infections in the bone marrow transplant recipient. Much of this progress is related to the availability of many new antimicrobial agents and biological products, as well as to an improved understanding of the pathogenesis of infections. Because of the expense associated with many of these agents and products, defensive strategies against infections must consider not only effectiveness but also cost (Table 16.9). It is now possible that a marrow transplant recipient could receive as many as five or six different prophylactic agents. While the use of an oral fluoroquinolone or oral fluconazole for prevention of serious bacterial and fungal infections is relatively inexpensive, the price of intravenous immune globulin and GM-CSF is considerably higher. Their routine use in all patients may not be economical. The results from ongoing trials comparing different dosing regimens of intravenous immune globulin and selectively using GM-CSF or G-CSF only in patients with suspected or documented infection will be important (80,173). On the other hand, the cost of providing CMV-seronegative blood products or prophylactic ganciclovir is justified by the high morbidity and mortality of CMV interstitial pneumonia in allotransplants. The low incidence of CMV disease in syngeneic transplants and autotransplants, however, makes CMV prophylaxis unnecessary. Similarly, in view of a recent controlled trial showing no benefit of intravenous immune globulin for prophylaxis of infections, intravenous immune globulin is also not needed in autotransplants. Trimethoprim-sulfamethoxazole is cheap prophylaxis for Pneumocystis carinii pneumonia, but the very low mortality from herpes simplex infection makes acyclovir a very expensive prophylaxis. Treatment options for the infected bone marrow transplant recipient have also become broader. The decline of Pseudomonas aeruginosa and other gram-negative bacillary infections and the availability of newer, more potent beta-lactam drugs makes monotherapy an appropriate and more cost-effective regimen for empiric therapy of many febrile patients. The introduction of fluconazole, itraconazole, and other newer antifungals offers promise for improving antifungal therapy, but these agents should not take the place of amphotericin B in a critically ill patient with suspected or documented fungal infection until results of ongoing controlled trials show equivalent efficacy. The role of biological response modifiers like macrophage colony-stimulating factor in the treatment of fungal infections also needs to be defined. Development of clinically applicable serologic tests for early detection of specific Candida or Aspergillus antigen is badly needed to help guide antifungal therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Prophylaxis and treatment of infection in the bone marrow transplant recipient. 839 16

We examined haemostatic abnormalities and thrombotic disorders in 217 patients with malignant lymphoma. Plasma levels of fibrinogen and D-dimer were significantly higher in patients with malignant lymphoma than in healthy subjects. The incidence of severe complications, such as disseminated intravascular coagulation (DIC) and interstitial pneumonia (IP), differed with each clinical stage or histological type, but they occurred frequently in stage IV or natural killer (NK) cell lymphoma. Plasma levels of fibrinogen degradation products (FDP) and D-dimer, leukocyte tissue factor (TF) mRNA and plasma TF antigen were significantly higher in stage IV than in stage I, II or III. Plasma levels of FDP, D-dimer, and leukocyte TF mRNA in NK cell lymphoma were markedly higher than in other types of lymphoma. Immunohistochemical staining of NK cell lymphoma revealed that granulocyte macrophage colony-stimulating factor was positive in tumour cells, whereas von Willebrand factor and TF were positive in vascular endothelial cells of surrounding tissue. Our results suggested that patients with stage IV disease and NK cell lymphoma were in abnormal thrombotic and haemostatic state, and may frequently develop DIC and IP. One of the mechanisms of DIC and IP may involve elevated cytokine production by lymphoma cells, which can stimulate the expression of TF in blood cells or surrounding tissue.
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PMID:Haemostatic abnormalities and thrombotic disorders in malignant lymphoma. 1563 Apr 82

Anti-MDA5 antibody is one of the dermatomyositis-specific autoantibodies and anti-MDA5-potsitive patients show characteristic clinical features, such as hypomyositis, high prevalence of acute/subacute interstitial pneumonia (A/SIP) with poor prognosis, hyperferritinemia and elevated hepatobiliary enzyme. We found that serum IL-6, IL-18, M-CSF and IL-10 were significantly higher and serum IL-12 and IL-22 were significantly lower in anti-MDA5-positive patients than in anti-MDA5-negative patients before treatment. Taking together these serological findings, we hypothesized that monocyte and macrophage activation may underlie in the pathophysiology of anti-MDA5-positive patients. They rarely survive after they become to need oxygenation, and so need to be treated as soon as possible once the diagnosis has been made. Intensive regimen of combined immunosuppressive therapy (high-dose corticosteroids, oral cyclosporin and intravenous cyclophosphamide (IVCY, 900-1000 mg/m(2) in every other week)) improved the survival rate of anti-MDA5-positive patients. Especially, the serum ferritin levels tended to go down about 14 days after IVCY, suggesting that IVCY might be a key drug in the treatment of anti-MDA5-positive A/SIP patients.
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PMID:[Anti-MDA5 (melanoma differentiation-associated gene 5) antibody and dermatomyositis with rapidly progressive interstitial pneumonia]. 2362 26