RESUMO
A previously healthy, non-smoking young man is presented who was briefly exposed to a high concentration of sulfur dioxide. An immediate episode of pulmonary edema was followed by a silent interval with subsequent development of a severe, irreversible obstructive syndrome. This history, together with radiographs showing hyperinflation and sequential physiologic studies indicative of obstruction without bronchospasm and without loss of parenchyma suggest bronchiolitis obliterans as the causative lesion. The literature concerning this syndrome and its relationship to toxic inhalation is briefly reviewed.
Assuntos
Pneumopatias Obstrutivas/induzido quimicamente , Dióxido de Enxofre/intoxicação , Adulto , Bronquite/complicações , Humanos , Pneumopatias Obstrutivas/diagnóstico por imagem , Masculino , Doenças Profissionais/induzido quimicamente , Edema Pulmonar/induzido quimicamente , Radiografia , Testes de Função RespiratóriaRESUMO
Patients with confirmed interstitial pneumonia were initially classified histologically into "desquamative" (n = 40) and "usual" (n = 53) types, and followed for one to 22 years. Both the diagnosis and the extent of fibrosis affected the course and response to therapy. Mortality in desquamative interstitial pneumonia was 27.5 per cent, and mean survival 12.2 years, as compared with 66.0 per cent and 5.6 years in usual interstitial pneumonia (P less than 0.01). Without treatment, 21.9 per cent with the desquamative but none with the usual type improved. With corticosteroid therapy, 61.5 per cent with desquamative and only 11.5 per cent with usual interstitial pneumonia improved, whereas 27.0 per cent and 69.2 per cent worsened. We conclude that the histologic classification of chronic interstitial pneumonia used here permits forecasts of prognosis and response to treatment that cannot be deduced from other data.
Assuntos
Fibrose Pulmonar/classificação , Adolescente , Corticosteroides/uso terapêutico , Adulto , Idoso , Feminino , Humanos , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Alvéolos Pulmonares/patologia , Fibrose Pulmonar/tratamento farmacológico , Fibrose Pulmonar/mortalidade , Fibrose Pulmonar/patologia , Testes de Função Respiratória , SíndromeRESUMO
Bilateral uveitis was the initial manifestation of a limited form of Wegener granulomatosis in a 47-year-old man. Diagnosis was established by biopsy of a pulmonary nodule. Subsequently, evidence of lesions developed in the patient's central and peripheral nervous systems, but renal lesions were absent. Pulmonary lesions regressed on therapy with azathioprine and prednisone. Blindness ultimately resulted from retinal phlebitis, vitreous hemorrhages, and neovascular glaucoma.