RESUMO
This report concerns a 28-year-old woman with biopsy-proved eosinophilic pneumonia and cutaneous vasculitis. The skin biopsy specimen contained prominent granular deposits of IgM and C3 in dermal vessels, and elevated circulating immune complexes were detected. The association of cutaneous immune complex vasculitis with circulating immune complexes in chronic eosinophilic pneumonia is unusual and to our knowledge has not been previously reported. While the pathogenesis of chronic eosinophilic pneumonia is unknown, circulating immune complexes may represent a mechanism in the development of tissue eosinophilia.
Assuntos
Eosinofilia Pulmonar/imunologia , Vasculite Leucocitoclástica Cutânea/imunologia , Adulto , Complexo Antígeno-Anticorpo/análise , Biópsia , Complemento C3/análise , Feminino , Humanos , Imunoglobulina M/análise , Pulmão/patologia , Eosinofilia Pulmonar/complicações , Pele/irrigação sanguínea , Pele/patologia , Vasculite Leucocitoclástica Cutânea/complicaçõesAssuntos
Obstrução das Vias Respiratórias/fisiopatologia , Albuterol/farmacologia , Etanolaminas/farmacologia , Compostos de Fenilureia/farmacologia , Adulto , Albuterol/administração & dosagem , Asma/fisiopatologia , Pressão Sanguínea/efeitos dos fármacos , Bronquite/fisiopatologia , Broncodilatadores , Ensaios Clínicos como Assunto , Feminino , Volume Expiratório Forçado , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Fluxo Máximo Médio Expiratório , Pessoa de Meia-Idade , Pico do Fluxo Expiratório , Fatores de Tempo , Capacidade VitalRESUMO
Endobronchial lipoma is a benign tumour of the large bronchi occurring in middle-aged men. To the 38 successfully treated cases in the English literature a further 2 are added. The symptoms are those of obstructive pneumonitis mimicking bronchogenic carcinoma, and the result of delayed therapy may be bronchiectasis. Treatment includes local resection through a bronchoscope or a bronchotomy incision, or removal, if necessary, of the obstructed lobe or lung at thoracotomy. Smoking may be important in the pathogenesis of this tumour.
Assuntos
Neoplasias Brônquicas/cirurgia , Lipoma/cirurgia , Adulto , Idoso , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/patologia , Diagnóstico Diferencial , Feminino , Humanos , Lipoma/patologia , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Fumar , Tuberculose Pulmonar/diagnósticoRESUMO
A history of respiratory atopy (seasonal hay fever or asthma) was sought among 218 patients with malignancy of endodermal origin (lung, gut, bladder, prostate), 104 patients with mesodermal malignancy (hematological, sarcomas, genitourinary system), 70 patients with ectodermal malignancy (skin and breast) and 303 age and sex matched controls. There was a significantly lower frequency of respiratory allergy in patients with endodermal malignancy when compared with their matched controls (6.4% compared to 13.2%, p less than 0.005). There were no significant differences among any of the other groups. Patients with respiratory atopy appeared to have some degree of protection against developing malignancies of endodermal origin. This may relate to immunologic factors, an inherent difference in the endodermal cell layer in atopic individuals or as yet undertermined factors.
Assuntos
Neoplasias Gastrointestinais/complicações , Neoplasias Pulmonares/complicações , Hipersensibilidade Respiratória/complicações , Neoplasias da Bexiga Urinária/complicações , Adulto , Idoso , Neoplasias da Mama/complicações , Doenças do Sistema Endócrino/complicações , Feminino , Humanos , Neoplasias Labiais/complicações , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias da Próstata/complicações , Neoplasias Cutâneas/complicações , Neoplasias da Língua/complicaçõesRESUMO
A 74-year-old woman with miliary tuberculosis had moderately severe hyponatremia due to inappropriate secretion of antidiuretic hormone (SIADH) and very severe thrombocytopenia without other hematologic abnormalities. She was treated with isoniazid, rifampin, ethambutol, prednisone, vincristine and fluid restriction and recovered completely. The SIADH may have been a response by the posterior pituitary to a decrease in intravascular volume resulting from the extensive pulmonary disease or associated hypoxia, or the tuberculous lung may have released ADH or an ADH-like substance. The thrombocytopenia may have resulted from a direct or indirect toxic effect of infection or, less likely, the tuberculosis may have activated latent idiopathic thrombocytopenic purpura.