Evaluation of Immunoglobulin Levels in Lavage Fluid in Active and Inactive Disease

Background: Fluid obtained by whole gut lavage usually contains traces of immunoglobulin (lg) G, albumin, and a-1-antitrypsin; higher concentrations have been found in patients with inflammatory bowel disease (IBD). Immunoglobulin (lg) levels increase in the lower respiratory tract of patients with pulmonary sarcoidosis. The aim of this study is to assess the Evaluation of immunoglobulin levels in lavage fluid in active and inactive disease. Material & Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of microbiology and immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. In Bangladesh for the duration of the period from October 2015 to March 2017. Results: This study shows that the according to age of 33 Patients aged 1 to 9 years. Here according to Age distribution, 2(6.1%) were 1-3 years, 10(30.30%) were >3 6 years, 9(27.27%) were >6-9 years and 12(36.4%) were >9 years. And according to gender 13(39.4%) were Male and 20(60.6%) were Female. Conclusion: The study concluded that high and abnormal levels of immunoglobulin (IgG, IgM, and IgA) is present among JIA patient in active disease state which became normal in inactive state.

Sarcoidosis pulmonar: actualización y reporte de casos / Pulmonary sarcoidosis: case report and update

RESUMEN Introducción: La sarcoidosis es una enfermedad multisistémica, granulomatosa, de etiología desconocida, con presentación clínica y curso evolutivo variable. El pulmón es el órgano más afectado (90% casos). Si bien el diagnóstico es anátomo-patológico, en situaciones particulares puede plantearse el mismo en base a hallazgos clínicos-radiológicos. El tratamiento está indicado en el paciente sintomático y/o en aquel paciente en el que se demuestra un compromiso funcional respiratorio. Se presenta el análisis de 7 casos de sarcoidosis de un centro de referencia nacional en intersticiopatías, según las manifestaciones clínicas, radiológicas, laboratorio respiratorio y la respuesta al tratamiento. Resultados: 7 pacientes (5 mujeres, 2 hombres) con edad promedio 47 años al momento del diagnóstico, tiempo promedio de seguimiento 9,7 años. 6/7 estaban sintomáticos al momento del diagnóstico. El funcional respiratorio era normal en 4 y en los 3 restantes tenía un patrón obstructivo. La difusión de monóxido de carbono fue normal en todos al momento del diagnóstico. Todos recibieron tratamiento con corticoides. De la re-evaluación se destaca que todos estaban asintomáticos y que la difusión de monóxido de carbono se mantuvo normal sólo en 4 de ellos. Discusión: Si bien se trata de una serie de pocos casos, presentaron una buena evolución clínica y funcional ante el tratamiento realizado como se observa en otros estudios publicados. No siendo así los resultados de la evolución radiológica

ABSTRACT Introduction: Sarcoidosis is a multisystem granulomatous disease of unknown etiology, clinical presentation and variable course. The lung is the most affected organ (90% cases). While the diagnosis is anatomopathological, in particular situations may arise based on the same clinical and radiological findings. Treatment is indicated in the symptomatic patient and / or one patient who demonstrated a respiratory functional compromise. analysis of 7 cases of sarcoidosis of a national reference center in intersticiopatías is presented, according to the clinical, radiologic, and laboratory respiratory response to treatment. Results: 7 patients (5 women, 2 men) with a mean age 47 years at diagnosis, 9.7 years average follow-up time. 6/7 were symptomatic at diagnosis. Respiratory function was normal in 4 and the remaining 3 had an obstructive pattern. Diffusion of carbon monoxide was normal in all at diagnosis. All were treated with corticosteroids. The re-evaluation stresses that all were asymptomatic and the diffusion of carbon monoxide remained normal in only 4 of them. Discussion: Although it is a series of a few cases, showed good clinical and functional evolution with the treatment performed as seen in other published studies evolution. Not being thus the results of radiology evolution.

Granulomatous Lung Disease: A Novel Complication following Metallosis from Hip Arthroplasty / 대한고관절학회지

A case of a female patient with local and systemic complications of metallosis, following catastrophic wear of a revised hip arthroplasty, is presented. The patient had a history of a fractured ceramic-on-ceramic implant, exchanged with a metal-on-polyethylene prosthesis. Systemic complications included sarcoidosis-like reactions, presenting as granulomatous lung disease, along with chorioretinitis, erythema nodosum, and cardiomyopathy. High local and circulating cobalt and chromium levels established the diagnosis. The patient underwent extensive debridement and implant revision. One year postoperatively, she had no respiratory symptoms or functional impairment. Local and systemic complications of metallosis after hip arthroplasty should be promptly recognized and treated operatively.

Sarcoidosis infantil: una rara enfermedad pediátrica: caso clínico / Childhood sarcoidosis: a rare pediatric disease: case report

Sarcoidosis is a systemic disease of unknown etiology. It affects various organs, including skin, eyes, joints, liver, heart, spleen and lymph nodes. Lungs are the organs most affected by this disorder and while symptomatology may vary thoughout life, most likely it is never diagnosed. It appears to be endemic in countries like England, US and Japan. The incidence is low in Mexico and Latin America. There is a genetic predisposition, where histocompatibility has a significant role. Histopathological diagnosis requires the presence of non-caseificating granulomatous lesions, with epiteloid cells with cytoplasmatic inclusions called Schaumann cells; these are diagnostic. The most severe complication is pulmonary fibrosis, which responds to steroids. We present the case of a school age child who was diagnosed as suffering from sarcoidosis after an open lung biopsy. Treatment with systemic steroids was initiated and is currenty asymptomatic, under observation and without complications secondary to treatment.

La sarcoidosis es un padecimiento multisistémico, de etiología desconocida. Afecta diversos órganos, entre los que se encuentran la piel, ojos, articulaciones, hígado, corazón, bazo y ganglios linfáticos. Los pulmones son el órgano más afectado en esta enfermedad, y aunque la sintomatología puede variar en cada etapa de la vida, lo común es que pase desapercibida en la mayoría de los casos. En algunos países como Inglaterra, Estado Unidos y Japón es endémica, en México y Latinoamérica su incidencia es baja. Existe una predisposición genética en la cual el complejo mayor de histocompatibilidad (HLA) tiene un papel predominante. El diagnóstico histopatológico requiere de la presencia en los tejidos de lesiones granulomatosas no caseificantes, células epiteloides e inclusiones citoplasmáticas llamadas células de Schaumann. La complicación más severa es la fibrosis pulmonar, por lo que el tratamiento con esteroides es de suma importancia. Presentamos el caso de un escolar al que se le realizo el diagnóstico de sarcoidosis pulmonar por biopsia pulmonar a cielo abierto. Al cual se le inicio tratamiento con esteroide sistémico y actualmente se encuentra bajo vigilancia, asintomático y sin complicaciones secundarias al tratamiento.

The diagnostic value of video bronchoscope-guide aspiration biopsy combined with transbronchial lung biopsy on pulmonary sarcoidosis / 中国综合临床

Objective To explore the diagnostic value of video bronchoscope-guide transbronchial needle aspiration(TBNA) combined with transbronchial lung biopsy(TBLB) on pulmonary sarcoidosis.Methods Twenty-two patients,definitely diagnosed as stage Ⅰ pulmonary sarcoidosis,were enrolled into the study and accepted TBNA and TBLB.Results The positive diagnostic rates of TBNA and TBLB were 63.6%(14/22) and 40.9%(9/22),but the rate increased to 90.9%(20/22) when the two methods were used together,which showed significant differences(x2=12.24,4.66,P＜0.01 or ＜0.05).Conclusion TBNA combined TBLB test is a safety method with high diagnostic accuracy for pulmonary sarcoidosis.

Pulmonary sarcoidosis: Classic radiographic finding.

We present the classic image findings of pulmonary sarcoidosis which is a rare disease in our country. A 31-year-old woman presents with an abnormal annual check up chest radiograph, which showed bilateral, symmetrical hilar nodes and a right paratracheal node enlargement without abnormal lung parenchyma. The physical examination, complete blood count, and blood chemistry, were unremarkable. Although many diseases can present with this abnormal image finding, but the combination of the nodal group involvement, the presence of intranodal calcification and nodal enhancement pattern, along with other pertinent positive findings on the chest CT scan, the diagnosis could be made.

A Case of Pulmonary Sarcoidosis in a 6-year-old Girl / 소아알레르기및호흡기학회지

Sarcoidosis is a rare multisystemic granulomatous disease. The lungs, lymph nodes, eyes, skin and liver are the most commonly involved. There are two distinct forms of sarcoidosis in children. One is early-onset(younger) childhood sarcoidosis characterized by skin rash, uveitis, and arthritis occurring before age 4 years. The other is late-onset(older) childhood sarcoidosis characterized by involvement of the lungs, the common radiographic finding is bilateral hilar lymph node enlargements, similar to the adult manifestation. We report a case of late-onset childhood sarcoidosis in a 6-year-old girl which is the first pediatric pulmonary sarcoidosis reported in Korea.