[Anti TNF beneficial of harmful for the lung?]

The Tumor Necrosis Factor is a pro-inflammatory cytokine which plays a key role in the pathogenesis of many diseases. Therefore, the anti Tumor necrosis factors have been used for treating many inflammatory pathologies such as rheumatoid arthritis or Crohn's disease with success. However, the use of these drugs has revealed during the formal years many side effects dominated by the tuberculosis. Lung cancer and asthma might be other side effects of the drugs. More recently they have been used for other pulmonary indications such as sarcoIdosis. Their benefits for treating asthma is being studied. Therefore, a wise use of these drugs is mandatory to benefit from good effects and avoid hamful

[Isolated bilateral pulmonary occlusion]

Takayasu's arteritis [TA] is an unusual cause of bilateral and isolated pulmonary artery occlusion that may be difficult to distinguish from other aetiologies. Report a new case of isolated bilateral pulmonary occlusion. A 19 year-old girl presented to the hospital with a 2-year history of dyspnoea and recurrent hemoptysis. She was in respiratory distress on physical examination Clinical investigations revealed a total occlusion of the right pulmonary artery on perfusion lung scan. Pulmonary angiogrphy confirmed these data and revealed further more a partially occluded left lower lobe artery. Diagnosis of Takayasu's arteritis was suspected and a complete aortogram was made but proved to be normal. Corticosteroid therapy was prescribed but interrupted within 2 months for absence of clinical improvement. Patient's assessment revealed worsening of the clinical condition and she became oxygendependant. Early diagnosis of isolated involvement of pulmonary arteries in TA while systemic arteries are normal may prove to be difficult. In spite of insufficient data to confirm TA, the latter seems to be the most probable diagnosis in our patient regarding clinical [young age] and angio graphic arguments