Pulmonary vasculitis in Behçet's disease.

Clinical findings of 12 patients with Behçet's disease and lung involvement are presented. Male to female ratio was 11/1, mean age was 35.3 +/- 8.8 yr. All patients had at least four other organ manifestations of vasculitis, either in their history or during the period of lung involvement. The main complaint was hemoptysis of varying degree in 11 of the 12 patients. The chest X-ray films showed unilateral hilar enlargements in six patients, diaphragm elevation in four, horizontally or obliquely oriented linear opacities in three, diffuse, ill-defined infiltrates in upper and lower zones in three, wedge-shaped peripheral opacities in one, and bilateral pleural effusion in one patient. Computed tomography of the chest performed in nine patients revealed aneurysms, narrowings, and cutoffs of the main, lobar, segmental, or peripheral branches of the pulmonary artery and irregular configuration of other pulmonary vessels. Perfusion scans demonstrated defects of various sizes in all patients. Pulmonary angiography performed in only two patients showed amputation of branches of the pulmonary artery and aneurysmal dilatations. The patients were treated with a combination therapy consisting of corticosteroid, cyclophosphamide, colchicine, and antiaggregants, with very good results in the short term.

[Exogenous allergic alveolitis caused by mouldy hazel nut leaves]. / Exogene allergische Alveolitis durch schimmelige Haselnusshüllblätter.

A 62-year old farmer woman from the northeastern, very rainy part of Turkey has been collecting large amounts of green and brown involucral hazel-nut leaves for subsequent use as fuel. For the last 20 years she had been complaining of cough, respiratory distress and intermittent fever. In the course of years of continual antigen exposure she developed the clinical and x-ray signs of fibrosis of the lung. Bronchoalveolar lavage produced the typical cell pattern of chronic exogenous allergic alveolitis with predominant CD8 cells. Serum analysis yielded high titres of IgG antibodies against mould fungi partly obtained from hazel-nut husk cultures, as well as thermophilic actinomycetes.

[Behçet's disease: a cause of hemoptysis]. / Behçet-Erkrankung: Als Ursache der Hämoptysen.

Behçet's disease should be considered in the differential diagnosis of haemoptysis. Pulmonary manifestations of Behçet's disease, which are due to the vasculitis of pulmonary vessels are quite rare. 8 cases who presented with haemoptysis and subsequently diagnosed as Behçet's disease will be presented. The value of diagnostic methods will be discussed. All patients yielded other manifestations of vasculitis such as aphtous stomatitis, genital ulcerations, cutaneous lesions, iridocyclitis and thrombophlebitis. Chest X-ray films yielded unilateral hilar enlargement in 3, unilateral elevation of diaphragm in 3, round and nonhomogenous opacities in 4 of 8 patients. Thorax CAT was performed in 5 of whom 4 showed aneurysms and irregularities of vessel walls. Pulmonary angiography of 2 patients displayed aneurysm and thrombosis. Perfusion defects of various sizes were evident in 7 patients obtained by pulmonary perfusion scans.