[Organizing pneumonia--analysis of 18 own cases]. / Organizujace sie zapalenie pluc--analiza 18 przypadków.

Organizing pneumonia (OP) is a rarely diagnosed disease, however the incidence ratio was estimated as 6-7/100000. Disease can occur in cryptogenic form or as a secondary reaction to various noxious agents, drugs, and ionising radiation, as a concomitant disease to infections, lympho- and myeloproliferative disorders, and connective tissue diseases. Symptoms of OP are non-specific therefore lung biopsy and histological examination are necessary for diagnosis. Eighteen cases of OP, 15 women and 3 men, aged 40 to 76 years, are presented with analysis of clinicopathological characteristic and therapeutic problems. In all cases diagnosis was confirmed by open lung biopsy. In one case radiotherapy and in one trastuzumab treatment was the cause of OP. In further 3 women antibodies against Chlamydia pneumoniae and in one--against Mycoplasma pneumoniae were found in serum. Probably Hashimoto disease was the cause of one case. In 12 patients the OP was idiopathic. Majority of patients were treated by prednisone (0.5 mg/kg). In one patient regression without any treatment was noticed and in other one--after cessation of trastuzumab. Five women were treated by clarithromycin. In 3 of them regression was observed but in other 2 corticotherapy was necessary. The observation period ranged from 1 month to 9 years, mean 34 months.

[Lung involvement in systemic lupus erythematosus (SLE)--own experience]. / Zmiany w ukladzie oddechowym w przebiegu tocznia rumieniowatego ukladowego--doswiadczenia wlasne.

Pulmonary disorders in systemic lupus erythematosus are frequent and sometimes they are the first symptoms of the disease. SLE may cause a variety of clinical presentations and pathologic patterns, which can be difficult to diagnose. We observed 11 patients (9 women and 2 men) with pulmonary manifestations of SLE during last 18 years in our department. Mean age of patients was 47.7 +/- 13.4 years. There were no patients with drug induced SLE. Interstitial lung diseases (7/11) acute or chronic and pleural involvement (5/11) were the most frequent clinical presentation. In three cases airway disease presented as reduction of FEV1%VC index was detected. In one case "shrinking lung" syndrome was confirmed by muscle function (diaphragm relaxation time) and lung function tests. Pulmonary hypertension confirmed by echocardiography, was associated with interstitial lung disease or vasculitis. Six cases representing different lung involvement pattern of SLE were described in details.

[Analysis of pulmonary function tests and cellular composition of bronchoalveolar lavage fluid in patients with sarcoidosis]. / Analiza badan czynnosciowych pluc i skladu komórkowego plynu z plukania oskrzelowo-pecherzykowego u chorych na sarkoidoze.

We investigated cellular composition of bronchoalveolar lavage fluid and changes in pulmonary function tests in patients with histopathologically proven sarcoidosis. We analyzed BAL, lung volumes, lung compliance, and diffusing capacity in 33 nonsmoking patients (18 males, 15 females, age 22-60 years, mean 40 years). In 39% of the patients we observed decreased static compliance and in 18% of patients reduction in diffusing capacity. The total cell count, percentage of lymphocytes and CD4/CD8 ratio and pulmonary function parameters in I, II and III radiological stages of sarcoidosis were similar. We found a moderate negative correlation between the carbon monoxide diffusing capacity (DLco% of pred.) and CD4/CD8 ratio (r = -0.40, p < 0.05). No correlation was observed between other pulmonary function indices and total cell count in BAL, percentage of lymphocytes and CD4/CD8 ratio. Our results suggest, that reduction in diffusing capacity may reflect an insensitivity of alveolitis, but correlation is moderate and it usefulness for making therapeutic decision is not clear.