A.V. Kristen , M.M. Borst , K. Andrassy , M. Kirschfink , J. Müller-Quernheim , H.A. Katus , F.J. Meyer
{"title":"Anti-oxidant and anti-inflammatory therapy in hypocomplementemic urticarial vasculitis with pulmonary emphysema","authors":"A.V. Kristen , M.M. Borst , K. Andrassy , M. Kirschfink , J. Müller-Quernheim , H.A. Katus , F.J. Meyer","doi":"10.1016/j.rmedx.2007.07.006","DOIUrl":"10.1016/j.rmedx.2007.07.006","url":null,"abstract":"<div><h3>Background</h3><p><span>Hypocomplementemic urticarial vasculitis (HUV) with </span>pulmonary emphysema<span> is associated with a poor prognosis, despite high-dose anti-inflammatory treatment including steroids.</span></p></div><div><h3>Objective</h3><p>A female former marathon runner, age 47 years, was diagnosed with HUV with skin, renal and pulmonary involvement. Pulmonary arterial pressure was increased during exercise, a novel finding in this disease entity. Complement consumption was associated with the presence of an anti-C1q autoantibody (IgG).</p></div><div><h3>Methods</h3><p>The initial treatment included high-dose steroids and chloroquine<span><span>. In analogy to other systemic inflammatory lung diseases, increased oxidant levels were postulated and high-dose </span>acetylcysteine<span> (NAC) was initiated. Later on, dapsone<span> as an inhibitor of pathologically increased neutrophil function was added.</span></span></span></p></div><div><h3>Results</h3><p><span>Within 3 months, this therapy resulted in a significant increase of the reduced serum complement<span> levels (CH50, APH50, C4A, and C4B), diffusing capacity, decrease of the anti-C1q autoantibody titer, and normalization of the increased </span></span>granulocyte count in the broncho-alveolar lavage. Additionally, a stepwise improvement of exercise tolerance (6-min walk test, oxygen consumption during exercise) was seen. Dapsone had no further effect on diffusing capacity or (did not affect) complement serum levels, which remained slightly reduced but stable despite the presence of the anti-C1q autoantibody. The effects have remained stable for the following 36 months. The therapy was well tolerated.</p></div><div><h3>Conclusions</h3><p>Antioxidant therapy with high-dose NAC might be a potential addition to the conventional anti-inflammatory therapy in patients with HUV and pulmonary involvement. It should be considered for investigation in a larger patient population.</p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.07.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73242284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Dutch patient with diffuse panbronchiolitis successfully treated with clarithromycine","authors":"G.J. de Vries , R.J. van Suylen , E.F.M. Wouters","doi":"10.1016/j.rmedx.2007.01.004","DOIUrl":"10.1016/j.rmedx.2007.01.004","url":null,"abstract":"<div><p><span><span>A case report of a 26-year-old Caucasian male with a medical history of </span>chronic sinusitis<span><span> and a “difficult to treat” asthma bronchiale is described. After a period of 6 years intensive medical treatment and diagnostic procedures, a </span>diffuse panbronchiolitis (DPB) was diagnosed, confirmed by histological examination. This case report describes the successful outcome of </span></span>macrolide<span> treatment in this patient. Despite the low incidence of DPB in western countries, physicians must be aware of this orphan disorder in order to provide adequate therapy.</span></p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.01.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72579971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
José Wellington Alves dos Santos, Fabiani Palagi Machado, Felipe Schaich, Douglas Zaione Nascimento, Tiago Teixeira Simon, Luis Fernando Cibin, Keli Cristina Mann, Vinícius André Guerra, Mateus Correa, Marcos Ferreira Gazzoni, Marta Pires da Rocha, Melissa Daubermann Falster, Ronaldo Manfredini Vassoler
{"title":"Unusual cavitary lung lesion in an asymptomatic patient—Case report and differential diagnosis","authors":"José Wellington Alves dos Santos, Fabiani Palagi Machado, Felipe Schaich, Douglas Zaione Nascimento, Tiago Teixeira Simon, Luis Fernando Cibin, Keli Cristina Mann, Vinícius André Guerra, Mateus Correa, Marcos Ferreira Gazzoni, Marta Pires da Rocha, Melissa Daubermann Falster, Ronaldo Manfredini Vassoler","doi":"10.1016/j.rmedx.2007.09.007","DOIUrl":"10.1016/j.rmedx.2007.09.007","url":null,"abstract":"<div><p>An unusual cavitary lung lesion in an asymptomatic and nonsmoker patient is uncommon. In these cases, infectious pathologies should be included in the differential diagnosis. Then, to correctly conduct an investigation, it is important to consider the clinical picture, the radiological images and the epidemiology. This presentation may need a wide variety of tests to establish the final diagnosis. Such a presentation occurs in the following case report.</p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.09.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78873503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. El-Gammal , M. O’Keefe , M. O’Driscoll , S. O’Reilly , T.M. O’Connor
{"title":"Association of testicular neoplasia and sarcoidosis","authors":"A. El-Gammal , M. O’Keefe , M. O’Driscoll , S. O’Reilly , T.M. O’Connor","doi":"10.1016/j.rmedx.2007.09.006","DOIUrl":"10.1016/j.rmedx.2007.09.006","url":null,"abstract":"<div><p><span>In this report, we highlight the association of sarcoidosis and </span>testicular cancer<span><span> in 3 patients and comment on the potential impact of this association on the interpretation of the radiological and pathological findings in suspected cancer. Sarcoidosis, a condition that can coexist with testicular cancer, should always be considered in the differential diagnosis of suspected metastases, particularly as intrathoracic </span>lymphadenopathy may be assumed to represent metastatic disease, which can have radical implications for patient therapy.</span></p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.09.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81284139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Napoli, S. Missori, A. Colatrella, S. Braucci, V. Della Chiara, V. Talucci
{"title":"Hiatal hernia and respiratory disturbs: Report of case","authors":"A. Napoli, S. Missori, A. Colatrella, S. Braucci, V. Della Chiara, V. Talucci","doi":"10.1016/j.rmedx.2007.08.003","DOIUrl":"10.1016/j.rmedx.2007.08.003","url":null,"abstract":"","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87121105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AnneMarie Mc Laughlin, Rosemary O’Brien, Seamas C. Donnelly
{"title":"Familial idiopathic pulmonary fibrosis occurring in four members of a family","authors":"AnneMarie Mc Laughlin, Rosemary O’Brien, Seamas C. Donnelly","doi":"10.1016/j.rmedx.2007.01.003","DOIUrl":"10.1016/j.rmedx.2007.01.003","url":null,"abstract":"<div><p>Idiopathic pulmonary fibrosis<span> (IPF) is a progressive fatal lung disease characterised by persistent pulmonary inflammation. Approximately 2% of cases are familial. Herein, we describe a family in which four members over two generations developed IPF. Of particular interest, the age of onset was lower in the second generation affected by the disease. Familial IPF offers a unique opportunity to study the proinflammatory processes implicated in IPF.</span></p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86247648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thoracic empyema due to Salmonella enteritidis infection in a patient with breast cancer","authors":"Hirokazu Tokuyasu , Ryota Okazaki , Etsuko Watanabe , Yuji Kawasaki , Ryo Maeda , Noritaka Isowa , Yasuto Ueda , Eiji Shimizu","doi":"10.1016/j.rmedx.2007.04.001","DOIUrl":"10.1016/j.rmedx.2007.04.001","url":null,"abstract":"<div><p>We report a rare case of thoracic empyema due to <em>Salmonella enteritidis</em> infection in a 79-year-old woman with breast cancer and diarrhea. The presence of the bacteria was determined by culturing the stool, blood, and pleural fluid. Although it is a rare occurrence, <em>Salmonella</em> empyema should be excluded in a febrile cancer patient with pleural effusion and a recent history of enteritis.</p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74733195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angelo G. Corsico , Rosanna Niniano , Elena Gatto , Maria C. Zoia , Andrea Corsico , Paolo Cremaschi , Ernesto Pozzi , Isa Cerveri
{"title":"“Nonobstructive” emphysema of the lung","authors":"Angelo G. Corsico , Rosanna Niniano , Elena Gatto , Maria C. Zoia , Andrea Corsico , Paolo Cremaschi , Ernesto Pozzi , Isa Cerveri","doi":"10.1016/j.rmedx.2007.09.011","DOIUrl":"https://doi.org/10.1016/j.rmedx.2007.09.011","url":null,"abstract":"<div><p><span>An unusual case of smoking-related centrilobular emphysema with normal </span>spirometry.</p><p>A 64-year-old man presented with severe dyspnoea and respiratory failure. Pulmonary function and mechanics were normal except for a marked reduction in diffusing capacity of the lung.</p><p><span>High-resolution CT scan showed diffuse centrilobular emphysema also involving lower lobes. </span>Pulmonary embolism<span>, cardiac or pulmonary shunt and immunopathologically based vasculitis were excluded. Pulmonary pressure was at the upper limit of normality but within few months he developed a severe pulmonary hypertension.</span></p><p>Although spirometry is the only physiologic measure recommended by the updated Global Initiative for Chronic Obstructive Lung Disease guidelines for confirming the diagnosis it should be recognized that diffuse emphysema may occur with only abnormalities in gas exchange without airflow obstruction. The identification of different phenotypes within COPD is important for understanding disease heterogeneity and progression.</p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.09.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91773632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Sereno , Alberto Chiappori , Frank Walsh , John Greene
{"title":"Unusual presentation of a complicated community-acquired pneumonia resembling lung cancer","authors":"Maria Sereno , Alberto Chiappori , Frank Walsh , John Greene","doi":"10.1016/j.rmedx.2007.04.004","DOIUrl":"10.1016/j.rmedx.2007.04.004","url":null,"abstract":"<div><p><span>We report a case of an unusual presentation of a complicated community-acquired pneumonia resembling lung cancer in an adult male with a long history of fever and consumption syndrome. Chest X-ray showed a right lower lobe consolidation and CT of the chest confirmed those findings. The bronchoscopy<span><span> demonstrated a mass obstructing the right lower lobe orifice and narrowing the intermedius and right bronchus. Although the picture resembled a lung cancer, two biopsies were consistent with chronic inflammation and features of </span>squamous metaplasia. He received several courses of empiric antibiotics (moxifloxacin and macrolides) without improvement. Cultures yielded </span></span><span><em>Streptococcus pneumoniae</em></span><span> and the antibiogram<span> indicated exhibited resistance to moxifloxacin. We started with Amoxicilin–Clavulanic with a clear clinical and radiological improvement. This is the first case report in USA of a community-acquired pneumonia resistant to moxifloxacin.</span></span></p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85296737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mycoplasma pneumoniae pneumonia presenting with febrile neutropenia","authors":"Aygul Dogan Celik, Alper Eker, Zerrin Yukugkural, Figen Kuloglu, Ozlem Tansel, Filiz Akata, Murat Tugrul","doi":"10.1016/j.rmedx.2007.02.003","DOIUrl":"10.1016/j.rmedx.2007.02.003","url":null,"abstract":"<div><p>A case of <em>Mycoplasma pneumoniae</em> pneumonia presenting with severe neutropenia, and diagnosed by immunoflourecence test is reported here. The patient was admitted to our clinic with severe neutropenia, and fever. During follow up a pneumonic consolidation was detected by thorax computerized tomography (CT) and anti-IgM was positive for <em>M. pneumoniae</em> serologically. It was concluded that neutropenia can develop due to <em>M. pneumoniae</em>.</p></div>","PeriodicalId":101082,"journal":{"name":"Respiratory Medicine Extra","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedx.2007.02.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72963862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}