Assuntos
Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Asma/tratamento farmacológico , Metilprednisolona/efeitos adversos , Metilprednisolona/uso terapêutico , Pneumonia por Pneumocystis/etiologia , Corticosteroides/administração & dosagem , Pré-Escolar , Humanos , Injeções Intravenosas , Masculino , Metilprednisolona/administração & dosagemRESUMO
We describe three persons in one family with diffuse lung infiltrates, digital clubbing, and chronic hypoxia. Elevated immunoglobulin levels and antinuclear antibodies were found in all patients; pathologic findings included hyperplastic lymphoid follicles infiltrating the epithelium of the small airways. These cases may represent a familial systemic autoimmune disorder seen primarily with pulmonary compromise.
Assuntos
Doenças Autoimunes/genética , Pneumopatias/genética , Tecido Linfoide/patologia , Adulto , Anticorpos Antinucleares/análise , Doenças Autoimunes/patologia , Cianose/patologia , Feminino , Dedos/patologia , Humanos , Hiperplasia , Imunoglobulina G/análise , Lactente , Pneumopatias/patologia , Masculino , Fibrose Pulmonar/patologiaRESUMO
In a randomized, double-blind, placebo-controlled, crossover study, inhalation of the commercially available nebulized form of cromolyn sodium resulted in a significant decrease in forced midexpiratory flow rate between the 25th and 75th percentile points, equivalent to that observed for distilled water, in children with chronic asthma. We conclude that inhalation of the current hypotonic concentration of cromolyn sodium may be detrimental.
Assuntos
Cromolina Sódica/efeitos adversos , Administração por Inalação , Adolescente , Asma/tratamento farmacológico , Asma/fisiopatologia , Criança , Método Duplo-Cego , Humanos , Soluções Hipotônicas , Soluções Isotônicas , Fluxo Máximo Médio Expiratório/efeitos dos fármacos , Testes de Função RespiratóriaRESUMO
Two patients with chronic granulomatous disease had obstructive lesions of the gastrointestinal tract, esophagus, and genitourinary tract, which were successfully treated with corticosteroids. These obstructive lesions, caused by local granuloma formation, have been reported in 18 other patients with chronic granulomatous disease, none of whom received steroids. Our first patient, a 3-year-old boy, had emesis and weight loss associated with antral narrowing and delayed gastric emptying at age 2 years. Antibiotic therapy was ineffective, but intravenous and oral corticosteroid therapy for 10 weeks resulted in clinical cure. One year later, dysuria associated with bladder neck obstruction was also treated successfully with corticosteroids. The second child, a 10-year-old boy, had dysphagia caused by distal esophageal stenosis. Corticosteroid therapy (with concomitant antibiotics) on two occasions reversed this obstruction. Granulomatous cystitis with ureteropelvic obstruction then developed, which also responded to treatment with corticosteroids and antibiotics. Despite the risk of increased susceptibility to infection, corticosteroid therapy is justified in preventing life-threatening obstruction of vital organs.