B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE最新文献

{"title":"A Difficult Diagnosis of Antineutrophil Cytoplasmic Antibody Associated Vasculitis with Sequential Organ Involvement","authors":"Muhammad Sajjadur Rahim, A. Omar, T. Varughese, L. Qingying","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2661","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2661","url":null,"abstract":"","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115734776","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 Rare Case of Lymphocytic Interstitial Pneumonia in Limited Scleroderma","authors":"A. Dursun, B. Giri","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2663","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2663","url":null,"abstract":"","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117174855","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":"Common Variable Immunodeficiency Presenting as Persistent Pneumonia with Pulmonary Mass","authors":"P. Shin","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2666","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2666","url":null,"abstract":"Introduction Common variable immunodeficiency (CVID) is a disorder of B cell differentiation leading to impaired synthesis of immunoglobulins. It is typically characterized by recurrent infections resulting from immunodeficiency but can also manifest as malignancy, granulomatous disease, and autoimmune disease. Case Report An 18 year old male with a past medical history of ITP secondary to mononucleosis presented with chief complaint of persistent fever for 2 months with associated intermittent nonproductive cough. He was raised in Mexico and denied any history of previous infections. He had been previously evaluated in the ED 2 months prior when he was treated for pneumonia. Chest x-ray at that time revealed a left sided patchy opacity, and the patient was discharged on a course of doxycycline. This initially improved his cough before symptoms returned and he additionally developed dyspnea, night sweats, and weight loss, prompting a second presentation. Physical examination was remarkable for tender posterior cervical lymph nodes on the left and diminished breath sounds at the left base. Laboratory studies were remarkable for a granulocyte predominant leukocytosis of 11.4. CT chest revealed a 6x5cm pulmonary mass at the left major fissure, mid esophageal thickening, diffuse lymphadenopathy, and splenomegaly. HIV, COVID-19, blood cultures, acid fast cultures, mono spot studies were all negative. The patient was started on levofloxicin for empiric treatment of bacterial pneumonia. CT guided biopsy of a lymph node revealed only reactive changes. An EGD was performed which did not visualize any esophageal changes, but did note gastric body erythema, with biopsies obtained. Biopsies resulted in a diagnosis of Heliobacter pylori infection. CT guided lung biopsy specimens grew multidrug resistant Streptococcus pneumoniae in culture. Flow cytometry was ordered due to concern for lymphoma which was nondiagnostic and showed no evidence of lymphocyte immaturity. Finally, immunoglobulins were quantified which demonstrated a deficiency of IgG (176), IgA (undetectable), and IgM (25). The patient was started on IVIG infusions with improvement of his symptoms. Discussion The diagnosis of CVID is often delayed by several years from its onset of symptoms. This is in part due to a wide variety of clinical manifestations and range of ages affected. Due to its variable presentation, CVID should be considered in cases of suspected lymphoma.","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"06 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130658383","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 Case of Recurrent Flare of PR3-ANCA-Negative Granulomatosis with Polyangiitis Complicated by ARDS and Fungal Pneumonia","authors":"R. Chadha, S. Dorobisz, A. Rosinski","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2662","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2662","url":null,"abstract":"","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"288 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122399557","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":"Mucous Membrane Pemphigoid: Below the Cords","authors":"M. Lannan, M. Izquierdo, N. Meier, J. Clinger, J. Jorizzo, L. Strowd, C. Wright, K. Thomas, A. Chatterjee","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2655","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2655","url":null,"abstract":"","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125705551","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":"Frightening and Not So Frightening: Is It Just Immunoglobulin G4-Related Disease (IgG4-RD)? A Case Series","authors":"C. Railwah, N. Martinez","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2648","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2648","url":null,"abstract":"","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129530431","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":"Navigating Through a Maze of Biological Agents to Treat Severe Eosinophilic Asthma and Inflammatory Bowel Disease","authors":"A. Go, J. Meland, G. Kamel, C. Boumitri, R. Nayak","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2653","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2653","url":null,"abstract":"","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131128420","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":"Eosinophilic Pneumonia Due to Eosinophilic Granulomatosis with Polyangiitis","authors":"G. Ha, S. Randhawa, S. Evans","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2652","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2652","url":null,"abstract":"","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132680279","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":"Adult-Onset Asthma, FDG-Avid Lung Nodule, and Periorbital Xanthogranulomas Due to IgG4-Related Disease","authors":"B. Samhouri, J. Ryu","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2647","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2647","url":null,"abstract":"","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131039095","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 Case of Acute Eosinophilic Pneumonia Following Tdap Vaccine","authors":"S. Perinkulam Sathyanarayanan, T. Naim, K. Shewbart, M. Baig, S. Helberg","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2651","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2651","url":null,"abstract":"Introduction: Acute eosinophilic pneumonia (AEP) is an uncommon lung disease. Its incidence and epidemiology remain understudied till date. The hypothesized etiology of AEP is an acute hypersensitivity reaction to an inhaled antigen such as tobacco smoke and other peculiar environmental factors. Vaccines as triggers of AEP, albeit very rare, have been reported in the literature. Case presentation: A 64-year-old male with history of hyperlipidemia on atorvastatin presented to the emergency room with complaints of cough productive of pink tinged sputum, exertional shortness of breath, chills and fever with maximum recorded temperature of 101 °F. His symptoms started within a few hours of receiving tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine two days ago. He denied any recent travel. He was a lifelong non-smoker and was employed as hospital case manager. His vitals were significant for tachycardia 116/min, tachypnea 30 breaths/min and SaO2 of 93 % on 10L. On physical examination, he was noted to have coarse and diminished breath sounds in both lung fields. Initial lab work showed elevated leukocyte count of 20.4 k/uL with absolute eosinophil count of 1.6 k/uL. Other labs were unremarkable. Diffuse bilateral reticulonodular and alveolar opacities were visualized on chest X-ray. Computed tomography (CT) of the chest showed profuse pulmonary nodules, scattered ground glass opacities and septal thickening concerning for bilateral multifocal pneumonia (figure 1). Blood cultures and sputum cultures were obtained and he was empirically treated with ceftriaxone and azithromycin. Sputum eosinophil smear was positive raising concerns for fungal and parasitic infections. Cultures remained negative and his hypoxia worsened. Thus, infectious diseases and pulmonology were consulted. Extensive infective disease work-up for bacterial, fungal, parasitic and viral pathogens came back negative. CT guided biopsy of a lung nodule demonstrated interalveolar eosinophil and fibrin deposition consistent with eosinophilic pneumonia (figure 2). Patient was started on glucocorticoids with dramatic improvement in his symptoms, imaging and oxygen needs. With his symptom onset following Tdap vaccine and negative infective work-up, AEP was suspected to be triggered by the vaccine. Discussion: AEP provoked by vaccination is rare. Cases have been reported with influenza, pneumococcal and also COVID-19 vaccines. To the best of our knowledge, this is the first report of AEP following Tdap vaccine in adults. Only up to 30% of patients with AEP will have peripheral eosinophilia. Diagnosis is usually confirmed on lung biopsy and patients respond very well to glucocorticoids.","PeriodicalId":276408,"journal":{"name":"B33. CASE REPORTS: IMMUNE CELLS GONE HAYWIRE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129259240","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}