Subject(s)
Hemorrhage , Lung Diseases , Occult Blood , Adolescent , Hemorrhage/diagnosis , Humans , Lung Diseases/diagnosis , Male , Therapeutic IrrigationABSTRACT
Evidence for severe intrapulmonary bleeding was obtained in 3 anticoagulated patients who presented with pulmonary infiltrates. The diagnosis of pulmonary hemorrhage was based on findings of markedly elevated quantities of stainable hemosiderin and hemoglobin in alveolar macrophages retrieved by bronchopulmonary lavage. In 2 of the patients, roentgenographic abnormalities regressed after anticoagulation was reversed. The third patient died and massive bilateral pulmonary hemorrhage was found at autopsy. The syndrome of occult pulmonary hemorrhage was characterized clinically by dyspnea, unexplained acute anemia, and infiltrates with an alveolar pattern on chest roentgenogram. Hemoptysis was conspicuously absent. Bronchopulmonary lavage and quantification of alveolar macrophage hemosiderin content may be useful in identifying intrapulmonary bleeding occurring in an otherwise occult manner. Recognition of pulmonary hemorrage in anticoagulated patients is important because reversal of anticoagulation can be life saving.
Subject(s)
Anticoagulants/adverse effects , Hemorrhage/chemically induced , Lung Diseases/chemically induced , Adult , Aged , Biopsy , Female , Hemoglobins/analysis , Hemorrhage/diagnosis , Hemorrhage/diagnostic imaging , Hemosiderin/analysis , Humans , Lung/pathology , Lung Diseases/diagnosis , Lung Diseases/diagnostic imaging , Macrophages/analysis , Male , Pulmonary Alveoli/analysis , Radiography , Therapeutic IrrigationSubject(s)
Carbon Monoxide/analysis , Pulmonary Diffusing Capacity , Humans , Mathematics , Pressure , Pulmonary Alveoli/analysisSubject(s)
Cytoplasm , RNA , Animals , Bile Acids and Salts/pharmacology , Carbon Isotopes , Detergents/pharmacology , Electrophoresis , Liver/cytology , Male , Microscopy, Electron , Microsomes, Liver/drug effects , Mitochondria, Liver , Molecular Weight , RNA/isolation & purification , Rats , Ribosomes , Surface-Active Agents/pharmacology , TritiumSubject(s)
Diethylstilbestrol/pharmacology , Oviducts/metabolism , Progesterone/pharmacology , RNA, Transfer/metabolism , RNA/metabolism , Age Factors , Amino Acids , Animals , Brain/embryology , Brain/metabolism , Cell Nucleus/metabolism , Chick Embryo , Chickens , Cytoplasm/metabolism , Electrophoresis , Female , Methods , Nucleosides/metabolism , Oviducts/embryology , RNA/biosynthesis , RNA/isolation & purification , RNA, Transfer/biosynthesis , RNA, Transfer/isolation & purification , Stimulation, Chemical , Tritium , Uridine/metabolismABSTRACT
Estrogenic hormones induce morphologic and biochemical differentiation in the oviduct of the immature chick. Concomitant with the hormone-stimulated tissue growth, there was an increase in 4S RNA, as judged by polyacrylamide-gel electrophoresis, and a corresponding increase in cellular transfer RNA activity, as measured by the amino acid acceptor capacity. This system may be suitable for studying the relation of hormones to transfer RNA in a differentiating tissue.
