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1.
Kyobu Geka ; 72(13): 1093-1096, 2019 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-31879387

RESUMO

The patient was a 52-year-old man who had undergone total arch replacement for type A aortic dissection 2 months before. He was admitted to our hospital with hemoptysis due to aortobronchial fistula. We planned to perform 1-stage open chest surgery, but he passed away before the surgery. We considered that earlier open surgery or emergency endovascular stent grafting might have been effective in avoiding this result.


Assuntos
Aneurisma Dissecante , Aneurisma da Aorta Torácica , Implante de Prótese Vascular , Fístula Brônquica , Implante de Prótese Vascular/efeitos adversos , Fístula Brônquica/etiologia , Emergências , Hemoptise , Humanos , Masculino , Pessoa de Meia-Idade , Stents
3.
Medicine (Baltimore) ; 98(44): e17798, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689858

RESUMO

RATIONALE: Dieulafoy disease of the bronchus is a rare vascular deformity. To the best of our knowledge, reports of these involving both lung vascular are hitherto absent. PATIENT CONCERNS: A 67-year-old male was admitted to our department due to agnogenic hemoptysis. DIAGNOSES: Bronchoscopy was performed and some smooth, pulsatile nodular lesions were found in the middle and lower lobes, Computed tomography angiography of the bronchial artery confirmed a left bronchial artery arising from the aortic arch at T4 level, and both bronchial arteries were dilated and tortuous. INTERVENTIONS: Bronchial artery embolization was performed successfully. OUTCOMES: The patient was discharged with no hemoptysis. In addition, patient is under follow-up until today without any further incidents. LESSONS: This case reminds us that Dieulafoy disease of the bronchus could be a potential etiology for unexplained hemoptysis. The clinician should be aware of this disease when bronchoscopy revealed multiple some smooth, pulsatile nodular lesions, thereafter, bronchoscope biopsy should be avoided, as it could lead to fatal hemoptysis.


Assuntos
Artérias Brônquicas/anormalidades , Broncopatias/complicações , Hemoptise/etiologia , Malformações Vasculares/complicações , Idoso , Artérias Brônquicas/cirurgia , Broncopatias/patologia , Broncopatias/cirurgia , Broncoscopia/métodos , Angiografia por Tomografia Computadorizada , Hemoptise/cirurgia , Humanos , Pulmão/patologia , Masculino , Malformações Vasculares/patologia , Malformações Vasculares/cirurgia
4.
Pan Afr Med J ; 33: 160, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31565122

RESUMO

Intra-alveolar bleeding is a rare and severe medical emergency due to numerous causes. We report the clinical case of a patient who could contribute to extend the literature on this subject. The study included a 62-year old man, with a history of a trial fibrillation, under anti-vitamins K antagonist admitted with dyspnoea of sudden onset associated with haemoptysis and practising self-medication using non-steroidal anti-inflammatory drugs. X-rays and chest scan showed diffuse bilateral alveolar opacities. Haemostatic screening tests on admission showed non-coagulable INR. The diagnosis of intra-alveolar bleeding was clinically and radiologically suspected and then confirmed by bronchial endoscopy with broncho-alveolar lavage (BAL) which detected uniformly hemorrhagic liquid. Previous studies of similar complications occurring after anti-vitamins K antagonists assumption are rare. In conclusion, it seems very important to emphasize the interest of strict and optimal clinico-biological monitoring of patients treated in anti-vitamins K antagonists to avoid an overdose which could contribute to a life-threatening severe haemorrhagic event.


Assuntos
Acenocumarol/efeitos adversos , Anticoagulantes/efeitos adversos , Hemorragia/induzido quimicamente , Alvéolos Pulmonares/patologia , Acenocumarol/administração & dosagem , Anticoagulantes/administração & dosagem , Dispneia/induzido quimicamente , Hemoptise/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Vitamina K/antagonistas & inibidores
5.
Medicine (Baltimore) ; 98(38): e17033, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567939

RESUMO

RATIONALE: Compared with most malignant tumors, papillary thyroid carcinoma (PTC) is usually associated with favorable survival and low recurrence rate. The prognostic factors of PTC include age, sex, tumor size, enlarged lymph nodes, and extrathyroidal extension. Among the extrathyroidal extension, upper aerodigestive tract (ADT) invasion by PTC is a marker of more aggressive tumor behavior, defining a subpopulation of patients at a greater risk of recurrence and death. PATIENT CONCERNS: A 61-year-old woman had a cervical mass that was slowly growing for three years. Additionally, she had haemoptysis of 1-year duration. During the month prior to her visit, she had difficulty breathing. DIAGNOSIS: Neck ultrasonography (US) and thyroid computed tomography (CT) images both showed a well-defined calcified mass on the left lobe of the thyroid gland. Additionally, the thyroid CT revealed that part of the mass protruded into the lumen which resulted in the thickening on the left side of the trachea. Accordingly, her diagnoses were as follows: firstly, a solid mass on the left lobe of the thyroid gland with tracheal compression; and finally, the space-occupying airway lesion. INTERVENTIONS: She underwent a bronchoscopic examination, which revealed a mass blocking most of the upper endoluminal trachea. Thus, the mass was resected at the upper tracheal segment, followed by electrotome and argon plasma coagulation treatment. She was then transferred to the Thyroid Surgery Department. Thyroid surgeons took the surgical type of bilateral subtotal thyroidectomy + exploration of bilateral recurrent laryngeal nerve + dissection of the lymph node in neck central area + circumferential sleeve resection + end-to-end anastomosis + tracheotomy in the patient. OUTCOMES: After surgery, she recovered well without any local recurrence or distant metastasis. LESSONS: When patients with PTC have haemoptysis, hoarseness, dyspnea, or any other symptoms, and the imaging examinations reveal a space-occupying lesion in the thyroid and airway, clinicians should focus on PTC with tracheal invasion, a bronchoscopic examination must be immediately performed because the subsequent surgical management depends on the degree of tracheal invasion.


Assuntos
Câncer Papilífero da Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Traqueia/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Hemoptise/etiologia , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/secundário , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/complicações , Neoplasias da Traqueia/secundário , Neoplasias da Traqueia/cirurgia , Ultrassonografia
6.
Medicine (Baltimore) ; 98(33): e16761, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415374

RESUMO

RATIONALE: Liver transplanted patients have excellent survival rates, but infectious complications are a major cause of morbidity and mortality. Diagnosis and treatment of tuberculosis (TB) in liver recipients are very challenging. Specific recommendations for anti-TB treatment in liver transplanted patients are lacking. PATIENT CONCERNS AND DIAGNOSIS: A 22-year-old male liver transplanted patient because of biliary atresia showed unexpected acute hemoptysis while he was on immunosuppressive therapy with tacrolimus and mycophenolate mofetil. Computed tomography (CT) identified a pulmonary arteriovenous malformation (PAVM) successfully treated with endovascular embolization. A post-embolization thoracic CT revealed pulmonary cavitation and miliary pattern suggesting pulmonary TB causing PAVM. TB diagnosis was confirmed by microbiological assays and genetic amplification techniques. INTERVENTION: Anti-TB 4-drug regimen was started. Following the beginning of treatment, liver enzymes increased. In order to clarify if liver cytolysis was due to hepatotoxicity or hepatic rejection linked to the reduction of immunosuppression or a worsening of pre-existing graft hepatitis, a liver biopsy was performed. A mild graft rejection was found so that tacrolimus doses were increased despite the risk of tubercular dissemination. OUTCOME: The patient completed anti-TB therapy in 8 months with resolution of TB disease and stable liver disease. LESSONS: TB management in liver transplanted patients is challenging and needs to be individualized especially if chronic graft hepatitis is present.


Assuntos
Rejeição de Enxerto , Hospedeiro Imunocomprometido , Transplante de Fígado , Tuberculose Pulmonar/diagnóstico , Antituberculosos/uso terapêutico , Diagnóstico Diferencial , Feminino , Hemoptise/etiologia , Humanos , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/tratamento farmacológico , Adulto Jovem
7.
BMJ Case Rep ; 12(8)2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31439567

RESUMO

A 67-year-man presented to the emergency department with massive hemoptysis, coughing up about 250 mL frank blood in 2-3 hours. Physical examination was significant for tachycardia, tachypnea and blood around the mouth. A CT of the chest did not reveal any aetiology of hemoptysis. Flexible fiberoptic bronchoscopy was remarkable for an actively oozing 1×1 cm sessile subglottic polyp on the anterior tracheal wall. CT neck revealed a 2.5×2.4 cm pretracheal soft tissue mass, bulging into the subglottic trachea. Fine needle aspiration confirmed papillary thyroid carcinoma with BRAF mutation. The patient underwent radical resection and surgical pathology confirmed a 2.5 cm papillary thyroid carcinoma with extensive extra-thyroid extension into the tracheal mucosa. Invasion of the trachea and surrounding structures like larynx and oesophagus is not usual for papillary thyroid carcinoma and may be associated with aggressive cancer behaviour and relatively poor outcome and prognosis.


Assuntos
Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Traqueia/diagnóstico , Idoso , Biópsia por Agulha Fina , Broncoscopia , Hemoptise/etiologia , Humanos , Masculino , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/secundário , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/diagnóstico por imagem , Neoplasias da Traqueia/secundário , Neoplasias da Traqueia/cirurgia
9.
J Cardiothorac Surg ; 14(1): 144, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31345241

RESUMO

BACKGROUND: Massive hemoptysis is a life-threatening condition and can arise as a complication of various conditions. It rarely occurs as a complication of a ruptured thoracic aortic aneurysm. Even rarer are conditions where pseudoanurysms of aorta result due to infection. CASE PRESENTATION: A 30 year-old female patient presented with left sided chest pain, intermittent fever, cough and massive hemoptysis. A pseudo-aneurysm of proximal descending thoracic aorta at the level of the left Subclavian artery was noted over CT scan. Upon performing a left posterolateral thoracotomy, the aneurysm was seen to have ruptured into the apical segment of left upper lobe, contained mainly by a thrombus. The anterior wall of the pseudoaneurysm was debrided and a bovine pericardial patch was used to repair the aortic defect. Cultures of the tissue obtained showed Enterobacter species, therefore the patient was prescribed 6 weeks of IV antibiotics following surgery. Post-operative CT scan revealed reduced diameter of the aorta. She was discharged in good health and remains well at follow up evaluation. CONCLUSIONS: We present a case of hemoptysis caused by a ruptured descending aorta aneurysm into left lung. The aneurysm was secondary to infection by Enterobacter. Surgical repair of the concerned region of aorta was effective, without any major sequelae. To the best of our knowledge, no such cases have been reported previously.


Assuntos
Aneurisma Infectado/diagnóstico , Aneurisma da Aorta Torácica/diagnóstico , Ruptura Aórtica/diagnóstico , Adulto , Aneurisma Infectado/complicações , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/cirurgia , Aneurisma da Aorta Torácica/complicações , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Ruptura Aórtica/complicações , Ruptura Aórtica/diagnóstico por imagem , Ruptura Aórtica/cirurgia , Dor no Peito/etiologia , Diagnóstico Diferencial , Feminino , Hemoptise/etiologia , Humanos , Toracotomia/efeitos adversos , Tomografia Computadorizada por Raios X
10.
BMC Infect Dis ; 19(1): 576, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31272486

RESUMO

BACKGROUND: Pleural parasitic infestation (PPI) is a disease prevalent in certain parts of the world. It is frequently misdiagnosed due to its lack of standardized diagnostic criteria. The purpose of this study was to evaluate the clinical characteristics of PPI patients and develop a practical diagnostic approach for PPI. METHODS: A retrospective study was conducted by reviewing the medical records of 11 patients with PPI. A practical diagnostic approach was proposed based on the unique laboratory findings. RESULTS: All patients demonstrated respiratory symptoms, including shortness of breath, cough, fever, chest pain, excessive sputum and hemoptysis. Leukocytosis (> 10,000/µL) and eosinophilia (> 500/µL) of peripheral blood were present in 45.5 and 36.4% patients, respectively. The mean concentrations of pleural effusion lactate dehydrogenase (LDH), adenosine deaminase (ADA), protein and carcinoembryonic antigen (CEA) were 338.2 U/L (range, 61-667 U/L), 11.6 U/L (range, 0.1-28.2 U/L), 43.7 g/dL (range, 21.9-88.1 g/dL), and 1.84 mg/mL (range, 0.28-4.8 mg/mL), respectively. The mean percentage of eosinophils in the pleural effusion was 19.5% (10.5-41%). Blood test was positive for parasite-specific IgG antibody in 9 patients, including 4 for Paragonimus westermani, 3 for Taenia solium, 1 for Clonorchis sinensis and 1 for Echinococcus granulosus. Eggs of Clonorchis sinensis were detected in the stool of two patients. Sparganum was found in the pleural effusion of one patient. Respiratory symptoms and abnormal appearances in pulmonary radiographic examination were disappeared in all patients who received anti-parasitic treatment. CONCLUSIONS: In patients with unexplained pleural effusion, parasite-specific IgG antibody tests should be performed when pleural fluid testing shows eosinophilic pleural effusion. It is preferable to consider the diagnosis of PPI in clinical practice when serum parasite-specific IgG antibody test is positive.


Assuntos
Imunoglobulina G/análise , Doenças Parasitárias/diagnóstico , Idoso , Dor no Peito , Tosse , Eosinófilos/patologia , Feminino , Febre , Hemoptise , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Parasitárias/parasitologia , Doenças Parasitárias/patologia , Derrame Pleural/metabolismo , Derrame Pleural/parasitologia , Estudos Retrospectivos , Escarro
11.
BMJ Case Rep ; 12(6)2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31253661

RESUMO

This is the case of a 33-year-old man with Behçet's disease who presented with recurrent haemoptysis and a rapidly expanding right pulmonary artery pseudoaneurysm. Due to the significant risk of major bleeding and death, he was promptly treated with an Amplatzer vascular plug.


Assuntos
Falso Aneurisma/complicações , Falso Aneurisma/terapia , Síndrome de Behçet/complicações , Artéria Pulmonar/patologia , Dispositivo para Oclusão Septal , Corticosteroides/uso terapêutico , Adulto , Falso Aneurisma/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Hemoptise/etiologia , Humanos , Masculino , Artéria Pulmonar/diagnóstico por imagem
12.
BMJ Case Rep ; 12(5)2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31151976

RESUMO

A 35-year-old male patient reached the emergency department after an episode of massive haemoptysis a few hours ago. Fever and dyspnea were mentioned to be present the last 5 days. His medical history included only malaria, successfully treated 2 years ago. Clinical examination revealed high fever, jaundice, cyanosis, tachypnea and bilateral rales on pulmonary auscultation. Laboratory investigation showed high erythrocyte sedimentation rate and C reactive protein, leucocytosis, anaemia, mild thrombocytopaenia, renal impairment, hyperbilirubinaemia and abnormal liver function tests; arterial blood gas analysis showed respiratory alkalosis with severe hypoxia. Thoracic X-ray revealed bilateral pulmonary infiltrates, whereas abdominal and heart ultrasound detected hepatomegaly and small pericardial infusion, respectively. The diagnosis of leptospirosis along with acute respiratory distress syndrome was confirmed by positive IgM Leptospira antibodies. Empirical treatment with triple antibiotic therapy and corticosteroids was applied. The patient was discharged after 1 week, without any symptoms and with almost normal laboratory tests.


Assuntos
Hemoptise/microbiologia , Síndrome do Desconforto Respiratório do Adulto/microbiologia , Doença de Weil/diagnóstico , Doença Aguda , Adulto , Doenças dos Trabalhadores Agrícolas/diagnóstico , Doenças dos Trabalhadores Agrícolas/microbiologia , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Humanos , Masculino , Doença de Weil/tratamento farmacológico
13.
Medicine (Baltimore) ; 98(23): e15893, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169699

RESUMO

RATIONALE: Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital anomaly characterized by the failure of fusion of embryologic pulmonary venous system with left atrium. PATIENT CONCERNS: A 45-year-old male patient with PAPVC who was hospitalized because of mild hemoptysis. Images showed the anomalous vein originated from the left upper pulmonary vein and flowed into the left brachiocephalic vein. No other underlying causes for hemoptysis were detected. DIAGNOSIS: After multi-disciplinary discussion, the patient was diagnosed as PAPVC of left upper pulmonary vein draining into the left brachiocephalic vein with intact atrial septum. INTERVENTIONS: Although surgical correction of PAPVC was feasible, left upper lobectomy was performed as the definitive treatment for both hemoptysis and PAPVC. OUTCOMES: The patient had an uneventful postoperative hospital course and was followed up for nearly 2 years without recurrence of hemoptysis. LESSONS: PAPVC is associated with atrial septal defect in 80% to 90% of cases while isolated PAPVC with intact atrial septum is an extremely rare entity. We present a rare isolated PAPVC patient with hemoptysis. To our best knowledge, PAPVC associated with hemoptysis has never been reported before.


Assuntos
Hemoptise/etiologia , Veias Pulmonares/anormalidades , Síndrome de Cimitarra/complicações , Síndrome de Cimitarra/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Cimitarra/diagnóstico
14.
Monaldi Arch Chest Dis ; 89(2)2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170777

RESUMO

It is uncommon for Systemic lupus erythematosus (SLE) to present with diffuse alveolar hemorrhage (DAH) as the initial presentation. To diagnose this in a young male with no renal involvement is further uncommon. We report a case of a 16-year-old boy, who presented with hemoptysis and was eventually diagnosed as DAH with underlying SLE. Treatment with steroids and immunosuppressant helped in rapid recovery from this potentially life-threatening condition. This case highlights the need of defining diagnostic criteria for SLE in patients presenting as DAH and formulating guidelines for treatment of the same, especially in absence of co-existing lupus nephritis.


Assuntos
Hemoptise/etiologia , Hemorragia/etiologia , Lúpus Eritematoso Sistêmico/complicações , Alvéolos Pulmonares/patologia , Adolescente , Glucocorticoides/administração & dosagem , Hemorragia/diagnóstico , Hemorragia/tratamento farmacológico , Humanos , Imunossupressores/administração & dosagem , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Masculino
15.
BMC Pulm Med ; 19(1): 104, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170962

RESUMO

BACKGROUND: Bronchial Dieulafoy's disease (BDD) is a rare disease that is known to be a cause of hemorrhage. The characteristics of this disease are still unknown. The present study describes the disorder based on a review of the world's literature, emphasizing the diagnostic and therapeutic views. METHODS: A comprehensive research of BDD of the PubMed, Google Scholar, and Web of Science databases was performed. The following data were collected: patient characteristics; chest imaging, bronchoscopy, vascular angiography, and histopathologic examination findings; and treatment rendered. RESULTS: 73 cases of BDD have been reported from 1995 to 2019. Most of the cases occurred in Asia (52.1%), followed by Europe (31.5%). Chest imaging findings were non-specific. The main bronchoscopy finding was a nodular or protruding lesion (60.9%). 19 patients underwent bronchoscopic biopsies, 17 had bleeding, and 6 died. Four patients were successfully shown to have vascular malformations under mucosal protrusion by endobronchial ultrasound scan (EBUS). Vascular angiography mainly showed tortuous, dilated bronchial arteries. Vascular angiography mainly showed tortuous, dilated bronchial arteries. The arterial supply was mainly provided by bronchial arteries (48 cases) and the pulmonary circulation (4 cases). The lesions were mainly located in the right bronchus (53 cases). Selective bronchial artery embolization (BAE) was attempted in 38 patients and 20 patients underwent lobectomies. Emergency resection was performed in 15 patients, all of whom survived and had no recurrent hemoptysis. CONCLUSIONS: Massive hemoptysis was the common manifestation of BDD. Vascular angiography and EBUS is a very useful examination before biopsy. BAE may be used in stable patients, or patients who cannot tolerate surgery, while surgical resection should be considered in patients who are unstable, patients with uncontrolled hemoptysis, or following BAE failure.


Assuntos
Brônquios/patologia , Broncopatias/diagnóstico , Hemoptise/diagnóstico , Adulto , Idoso , Angiografia , Broncopatias/cirurgia , Broncoscopia , Embolização Terapêutica , Feminino , Hemoptise/etiologia , Hemoptise/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
17.
BMC Pulm Med ; 19(1): 117, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248409

RESUMO

BACKGROUND: Although infections caused by nontuberculous mycobacteria (NTM) are increasing in prevalence, there are few data about hemoptysis in patients with NTM lung disease. This study investigated the characteristics and prognosis of hemoptysis secondary to NTM infection. METHODS: Following a retrospective review of cases managed between 2006 and 2016, 183 patients with NTM lung disease were enrolled and analyzed. RESULTS: Among 183 patients with NTM lung disease, Mycobacterium intracellulare (n = 64, 35%) was the major cause of NTM infection, followed by M. avium (n = 59, 32.2%) and M. abscessus complex (n = 40, 21.9%). Hemoptysis developed in 78 patients (42.6%), among whom 33 (42.3%) required bronchial artery embolization (BAE). Between patients with and without hemoptysis, there were no significant differences with respect to sex, radiographic manifestations, distribution over 3 lobes on chest computed tomography, history of pulmonary tuberculosis, antiplatelet or anticoagulation therapy, and species of NTM. However, mean age at diagnosis was significantly lower in the hemoptysis group in univariate and multivariate analyses (65.7 ± 12.8 vs. 59.7 ± 11.8, P = 0.002, odds ratio: 0.969, 95% confidence interval: 0.944-0.996). Among patients with hemoptysis, those requiring medical therapy and those requiring BAE were not significantly different in terms of demographic characteristics, radiographic manifestations, and distribution over 3 lobes. All patients who received BAE showed immediate clinical improvement, no procedure-related complications, and none of them died during the period under review. CONCLUSIONS: NTM lung disease patients commonly experienced hemoptysis without specific risk factors except for relatively young age. Although some patients with hemoptysis needed BAE, the success rate of BAE was high, and there were no serious complications associated with BAE.


Assuntos
Artérias Brônquicas , Embolização Terapêutica/métodos , Hemoptise/etiologia , Hemoptise/terapia , Infecção por Mycobacterium avium-intracellulare/complicações , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(6): 589-593, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31208515

RESUMO

A girl was diagnosed with intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) due to pyrexia and hemoptysis for eight days. The girl was a school-age child with major clinical manifestations of pyrexia, skin rash, enlargement of bilateral cervical lymph nodes, conjunctival hyperaemia, red and cracked lips and strawberry-like tongue, followed by swelling of both hands and feet. Laboratory examination showed significant increases in white blood cell count, platelet count, C-reactive protein, erythrocyte sedimentation rate and liver enzymes, a significant reduction in albumin, and the presence of aseptic pyuria. After the first course of IVIG treatment, the girl still had recurrent pyrexia, with hemoptysis on day 2 after admission, and lung CT showed uneven luminance and patchy shadow. The symptoms were quickly alleviated after the second course of IVIG treatment combined with methylprednisolone and aspirin treatment. KD is a febrile disease characterized by multiple systemic vasculitis in childhood and can involve various organ systems such as the heart, lungs, kidneys and the nervous system. Therefore, it is necessary to carefully monitor and recognize the rare symptoms of KD, and early recognition of pulmonary complications of KD can avoid delay in diagnosis, prevent the development of more serious complications, and help with early treatment and disease recovery.


Assuntos
Hemoptise , Síndrome de Linfonodos Mucocutâneos , Sedimentação Sanguínea , Criança , Feminino , Febre , Humanos , Imunoglobulinas Intravenosas
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