[Allergic bronchopulmonary aspergillosis: a review of 3 cases]

Allergic bronchopulmonary aspergillosis [ABPA] is a rare affection, initially described in 1952. Its pathophysiology incriminate several mechanisms in relation with the organism of the patient and the bronchial colonisation by the fongic agent. To report three cases of ABPA. Three patients had been treated for ABPA in Ibn Nafiss department in Abderrahmen Mami hospital in Ariana. ABPA had been discovered in the three cases by a corticodependant asthma, refractory for different therapeutics. Positif diagnosis reposed in the 3 patients at 6 major and one minor criterion. Traitment was essentially based in corticotherapy. Positif diagnosis of ABPA is actually well established, however, its traitement, although based on corticotherapy, remind not clearly codified. Association of antifongic treatment may improve the prognosis

[Thoracic manifestations of systemic lupus erythematosus]

Systemic lupus erythematosus [SLE] is an autoimmune disease. The respiratory system is more commonly involved in SLE than in any other collagen vascular disease. To study the pleuropulmonary manifestations of SLE. Retrospective study including 10 patients hospitalized between January 2000 and December 2008 for pleuro-pulmonary manifestation revealing or complicating the SLE. Nine women and only one man aged between 21 and 67 years-old were included in this study. Two patients had already SLE and for the other patients the pleuro-pulmonary manifestations were revealing the SLE. Pleural effusion was the most common manifestation witch represents 50% of the patients. For the other patients we find one case of interstitial pneumonia, one case of pulmonary embolism, on case of pneumonia, on case of pulmonary haemorrhage and on case of pulmonary hypertension. All these patients were treated by corticoids and only one patient takes high doses of corticoids for managing a massive pulmonary haemorrhage. The evolution was favourable for 9 patients, one patient dead because of massive pulmonary haemorrhage complicated with acute respiratory failure. Pleuro-pulmonary involvement in SLE is common and may be life threatening, in which case prompt and aggressive treatment is mandatory

[Neoplasic vena cava syndrome]

Vena cava superior syndrome results of an obstruction of superior vein cava [SVC] and/or brachiocaphalic venous troncs by extrinsic compression and/or by tumoral or cruoric thrombosis. The bronchopulmonary cancer represents the most frequent aetiology. The aim of this study is to establish clinical, radiological, evolutive profiles and modalities of treatment of neoplastic vena cava superior syndrome independently of its histological type. It is a retrospective study about 20 patients presenting vena cava superior syndrome compliquating primary bronchopulmonary cancer, hospitalized between January 2000 and December 2007 in Ibn Nafiss department in Abderrahmen Mami hospital. All patients were males with an average of 57, 8 years. Vena cava superior syndrome had revealed cancer in 60% of cases. It was metachrone in 40% of the patients. The most frequent histological type was small cell lung cancer. Treatment was proceeded in 2 steps, symptomatic and etiologic for the bronchopulmonary cancer. The bronchopulmonary cancer is the most frequent aetiology of vena cava superior syndrome. Its treatment is actually well codified

Application d'un algorithme decisionnel au diagnostic de l'embolie pulmonaire non grave en milieu pneumologique: Resultats d'une etude prospective de 40 cas

We have study prospectively cases of non severe pulmonary embolism in a pulmonary department by an analysis based strategy associating radio-clivical probability, venous ultra sonography, D-Dimers value followed, if no performed diagnosis, by pulmonary scintigraphy or angio-CT scan. 64 cases of pulmonary embolism suspicion have been hospitalised in our department between October 1998 and July 2001; 40 patients was included in our study and have been classified in 3 groups regarding pre test clinical probability. Anticoagulant treatment has been initialised only in the third group [probability > 80%]Clinical probability associated with venous ultra sonography and D- Dimeres value allow or exclude pulmonary embolism diagnosis in 27 patients. In the others, scintigraphy and angio CT scan were necessary for establishing diagnosis. Application of this algorithm allow diagnosis of pulmonary embolism in 29 patients and exclude this pathology in the other 11. None of this patient complained from recurrent thrombo embolic accident during 17 to 42 months observance period