ABSTRACT
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Subject(s)
Humans , Male , Young Adult , Aspergillosis, Allergic Bronchopulmonary , Radiography, Thoracic , Adrenergic beta-Agonists/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Aspergillus/pathogenicityABSTRACT
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Subject(s)
Humans , Male , Aged , Trachea/abnormalities , Bronchi/abnormalities , Respiratory System Abnormalities/diagnosis , Solitary Pulmonary Nodule/diagnosis , Diagnosis, DifferentialABSTRACT
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Subject(s)
Humans , Male , Female , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/complications , Sex Distribution , Anti-Bacterial Agents/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Adrenergic beta-Agonists/therapeutic use , Tobacco Use Disorder/epidemiologyABSTRACT
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Subject(s)
Humans , Hypertension, Pulmonary/physiopathology , Respiratory Function Tests , Respiratory Physiological Phenomena , Dyspnea/physiopathology , Quality of Life , Exercise Test/methodsABSTRACT
OBJECTIVE: To assess retrospectively the utility and the profitableness of the diagnostic procedures and techniques in patients with idiopathic BOOP. MATERIAL AND METHODS: We studied epidemiological features, clinical manifestations, respiratory function tests, chest radiology, and other diagnostic procedures and techniques, as well as the evolution and the mortality rates in patients with histological diagnosis of idiopathic BOOP during the period 1992-1999. RESULTS: 20 patients (55% F, 45% M). Age: 64 +/- 15 years old, 50% smokers. The mean period elapsed since the beginning of the symptoms and the time of diagnosis was 51 +/- 30 days. The clinical presentation is of a subacute influenza-like illness, with fever, cough, dyspnea and crackles. The more common abnormalities were. WBC (10,949 +/- 2,6429 mm3, ESR 85 +/- 86 UI/L, LDH 309 +/- 86 UI/L. Arterial blood gas: PaO2 64 +/- 9, PaCO2 35 +/- 3 mmHg. Pulmonary function tests: VCF 81 +/- 25%, FEV1/VCF 78 +/- 17%, TLCO 74 +/- 9%, TLCO sb 77 +/- 4%. Radiological evaluation: bilateral multiple patchy alveolar opacities 75%), solitary focal lesion (15%) and interstitial opacities (10%). The bronchoscopy and BAL 10/20 (50%). Transbronchial biopsy 12/20 wit diagnosis (60%). The video assisted thoracoscopic lung biopsy 1/20 (5%) and open lung biopsy 7/20 (35%). Recurrences 8/20 (40%). Mortality rate 3/20 (15%). CONCLUSIONS: The idiopathic BOOP is a benign entity clinic inespecific, associated to hypoxemia and bilateral alveolar opacities. The transbronchial biopsy is a diagnostic procedure alternative to the open lung biopsy, in a compatible clínico-radiological context. The response to treatment is acceptable although it presents frequent exacerbations, and low mortality rate.
Subject(s)
Cryptogenic Organizing Pneumonia/diagnosis , Cryptogenic Organizing Pneumonia/therapy , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Objetivo: Estudio retrospectivo de la utilidad y rentabilidad de las técnicas y procedimientos diagnósticos en pacientes con BONO idiopática. Material y métodos: Pacientes con diagnóstico histológico de BONO idiopática periodo (1992-1999). Realizándose análisis demográficos, manifestaciones clínicas, laboratorio, funcionales, radiológicas, procedimientos y técnicas de diagnóstico, evolución y mortalidad. Resultados: 20 pacientes (55 por ciento) M, (45 por ciento) V. Edad 64 ± 15 años, 50 por ciento fumadores. Intervalo entre inicio clínico y diagnóstico 51 ± 30 días. Un cuadro pseudogripal, junto a fiebre, tos, disnea y estertores crepitantes fueron las manifestaciones más frecuentes. Leucocitosis (10.494 ± 2.642) células/mm3,VSG 85 ± 86 UI/L, LDH 309 ± 86 UI/L. Gasometría arterial: PaO2 64 ± 9, PaCO2 35 ± 3 mm de Hg. Función respiratoria: CVF 81 ± 25 por ciento, VEF1/CVF 78 ± 17 por ciento, DLCO 74 ± 9 por ciento, KCO 77 ± 4 por ciento. Rx: opacidades alveolares múltiples bilaterales (75 por ciento), nodulares solitarias (15 por ciento) e intersticiales (10 por ciento). Fibrobroncoscopia y lavado broncoalveolar 10/20 (50 por ciento). Biopsia transbronquial 12/20, siendo diagnóstica en (60 por ciento). Videotoracoscopia 1/20 (5 por ciento) y biopsia abierta pulmonar 7/20 (35 por ciento). Exacerbaciones 8/20 (40 por ciento), falleciendo 3/20 (15 por ciento) pacientes. Conclusiones: La BONO idiopática es una entidad benigna, clínicamente inespecífica asociada a hipoxemia moderada y opacidades alveolares bilaterales. La biopsia transbronquial constituye una técnica diagnóstica alternativa a la biopsia abierta pulmonar en un contexto clínico-radiológico compatible. La respuesta al tratamiento es buena, presentando frecuentes exacerbaciones y baja mortalidad. (AU)
Subject(s)
Middle Aged , Male , Female , Humans , Cryptogenic Organizing Pneumonia , Retrospective StudiesABSTRACT
We present a 69 years old male patient diagnosed of rheumatoid arthritis (RA) with signs of pleuropulmonar disease. The diagnose of RA was done of 49 years and since then treated with non steroid antiinflammatory drugs and during the acute phases of RA with steroid drugs. The pleural effusions showed an exudate with pseudochilothorax criteria with acid pH acid low glucose concentrations. The cytological study of the effusion demonstrated the presence of characteristic mononuclear cells.
Subject(s)
Arthritis, Rheumatoid/complications , Pleural Effusion/cytology , Pleural Effusion/etiology , Aged , Arthritis, Rheumatoid/diagnosis , Diagnosis, Differential , Humans , Male , Pleural Effusion/diagnosisABSTRACT
We present the case of a 59 years old male with Wegener's Granulomatosis with uncommon manifestations such as diffuse pulmonary hemorrhage and acute renal failure due to necrotizing glomerulonephritis. Neutrophil anticytoplasmic antibodies determination was negative. Conventional and high resolution thoracic computed tomography showed cavitated lung nodules with small peripheral vessels. These lesions, that are characteristic of this type of vasculitis, were not appreciated on the routine chest roetgenogram. Definitive diagnosis was made by the histological study of open lung and renal biopsies. Favourable response to corticosteroids, immunosuppressive drugs and hemodialysis was obtained. Diffuse pulmonary hemorrhage is an uncommon manifestation of Wegener's Granulomatosis, and must be considered as a vital emergency that justify the use of aggressive diagnostic and therapeutic methods.
