RESUMEN
Two patients with granulomatous lung lesions thought to be related to Crohn's disease (CD) are reported. Patient 1 was a 43-year-old man who was diagnosed with CD at age 11 years. He developed a fever in the 38 °C, and a chest X-ray and CT scan showed infiltrates with air bronchograms in the right upper lobe and left lingular segment. Transbronchial lung biopsy (TBLB) revealed granulomatous lesions. Patient 2 was a 76-year-old woman who was diagnosed with CD at age 44 years. Chest CT showed infiltrates and nodular shadows in both lung fields. Video-assisted thoracoscopic surgery (VATS) in June 2012 revealed granulomatous lesions. Tuberculosis, fungal infections, drug-induced lung disorder, and sarcoidosis were ruled out as a cause of the granulomatous lesions in both patients. The aetiology was thought to be CD.
RESUMEN
The prognosis of idiopathic pulmonary fibrosis (IPF) is poor, and it deteriorates when it is complicated with pulmonary hypertension (PH). Forced vital capacity (FVC) is a useful parameter for evaluating the disease status of interstitial pneumonia (IP). However, in patients with IP complicated with emphysema, the disease severity can be overlooked because of relatively well preserved FVC. We investigated the correlation between the maximum pressure gradient (PG) in the tricuspid valve using echocardiographic measurements and pulmonary function tests in patients with IP without emphysema and in those with IP with emphysema. There was an inverse correlation between PG and %FVC in patients with IP without emphysema. However, the above inverse correlation between PG and %FVC mentioned above disappeared when analyzed in the whole cohort of patients (n = 42) consisting of IP without emphysema (n = 35) and IP with emphysema (n = 7). Patients with IP without emphysema did not show a correlation between PG and %FEV1, but when analyzed using the whole cohort of patients an inverse correlation between PG and %FEV1 was observed (p<0.05). In clinical practice, not only FVC, but also %FEV1 is a valuable parameter in investigating the complication of emphysema and PH in patients with chronic idiopathic interstitial pneumonia.
