Assuntos
Linfoma de Células B/diagnóstico por imagem , Neoplasias Pleurais/diagnóstico por imagem , Tuberculose Pulmonar/complicações , Idoso , Diagnóstico Diferencial , Humanos , Masculino , Tomografia Computadorizada por Raios X , Tuberculose Pleural/diagnóstico por imagem , Tuberculose Pulmonar/diagnóstico por imagemRESUMO
Environmental exposure to asbestos, as observed in Anatolia (Turkey), usually results in pleural pathology (plaques and mesothelioma). We report the case of a 50-year old woman who, until the age of 50, had lived in Eregli, central Anatolia, a region where inhalation of environmental asbestos is responsible for a high prevalence of pleural diseases. Radiology showed diffuse interstitial pneumonia without pleural involvement. Bronchoalveolar lavage brought back asbestos bodies (AB) in concentrations of 4,250 per millilitre. All were made of tremolite, a non-commercial variety of asbestos. The patient's family was investigated by chest radiography and search for AB in sputum. The husband, who came from the same town as his wife and had been exposed until the age of 45, had the classical response with bilateral pleural thickening but no parenchymal abnormalities; 2 AB were found in his sputum. The 3 sons, exposed for 10, 13 and 20 years respectively, had normal radiograms and no AB in their sputum, except for the older (3 AB) who had been exposed for 20 years. These cases illustrate the importance of environmental exposure to asbestos which may produce lesions similar to those observed in industrial exposure. Only mineralogical examinations can determine whether the asbestos is environmental or industrial.
Assuntos
Amiantos Anfibólicos , Amianto/efeitos adversos , Fibrose Pulmonar/etiologia , Líquido da Lavagem Broncoalveolar/química , Exposição Ambiental , Feminino , Humanos , Pessoa de Meia-Idade , Linhagem , Fibrose Pulmonar/diagnóstico por imagem , Fibrose Pulmonar/genética , Ácido Silícico/efeitos adversos , Tomografia Computadorizada por Raios X , TurquiaRESUMO
The authors present 2 cases of mycoplasmal pneumonia associated with severe haemolysis. Haemolytic anaemia is a well-known and habitually mild complication of the disease. It is related to a peak of cold agglutinins, which are antibodies that agglutinate red blood cells usually at low temperatures but sometimes at 37 degrees C when they are present in high concentrations. The pathogenesis of cold agglutinins is thought to involve the secretion of peroxides by Mycoplasma pneumoniae with alteration of ed cell antigens which become immunogenic.