ABSTRACT
Tracheobronchopathia osteochondroplastica (TO) is an unusual disorder. It mainly affects men over 50 years old and clinical manifestations are observed when obstructive or infectious complications occur. A 50-year old woman was investigated because of productive cough and 42 years old man was investigated because of haemoptysis. In two cases, at bronchoscopy, the typical picture of TO was observed. Microscopic examination of the biopsy material revealed bone formation. TO should be considered in the differential diagnosis as an unusual cause of chronic persistent cough, haemoptysis, persistent atelectasis, and recurrent segmental or lobar infection.
Subject(s)
Bronchial Diseases/diagnosis , Osteochondrodysplasias/diagnosis , Tracheal Diseases/diagnosis , Adult , Bronchial Diseases/complications , Bronchial Diseases/pathology , Cough/etiology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Osteochondrodysplasias/complications , Osteochondrodysplasias/pathology , Tracheal Diseases/complications , Tracheal Diseases/pathologyABSTRACT
The precise clinical manifestations of tuberculosis are likely to result from a complex interaction between the host and the pathogen. We took serum samples from a group of patients with a variety of clinical and radiological stages of pulmonary tuberculosis in order to characterize tumor necrosis factor-alpha (TNF-alpha), interleukin-4 (IL-4) and soluble interleukin-2 receptor (sIL-2R) response. We further evaluated whether the levels of TNF-alpha, IL-4 and soluble IL-2R are related with each other, and also evaluated the levels of TNF-alpha, IL-4 and sIL-2R after anti-tuberculosis therapy and relation with radiologic scores. Forty-three inpatients with active pulmonary tuberculosis and 19 healthy controls participated in the study. Patients were divided into four categories radiologically on chest X-ray (minimal, moderate-advanced, far-advanced and with miliary infiltration). Concentrations of TNF-alpha (20.9+/-10/15.4+/-8 pg/ml) and sIL-2R (2569+/-842/1444+/-514 pg/ml) were statistically different between patients and controls (p=0.02 and p=0.0001, respectively). Before chemotherapy there was a positive correlation between TNF-alpha and sIL-2R (r=0.34), but there was no correlation between IL-4 and TNF-alpha, and between IL-4 and sIL-2R (r=-0.23 and r=-0.22). The TNF-alpha level was not statistically different in four groups before and after chemotherapy. Results of this study provided some evidence confirming the previously reported role of TNF-alpha, IL-4 and sIL 2R in the control of tuberculosis, but these cytokines were not found related with disease severity.
