scholarly journals A150 INFLIXIMAB INDUCED EOSINOPHILIC PNEUMONITIS IN AN ADOLESCENT

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 152-154
Author(s):  
E Carrión-Jaramillo ◽  
M Chilvers ◽  
C Barker
Keyword(s):  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Nasal Congestion ◽  
Pulmonary Function Tests ◽  
Skin Testing ◽  
Fungal Growth ◽  
High Dose ◽  
Delayed Presentation ◽  
Peripheral Eosinophilia ◽  
Bronchodilator Effect

Abstract Background Infliximab is used to induce and maintain remission of inflammatory bowel disease (IBD). Pulmonary abnormalities in IBD are rare, but comprise airway, parenchymal and interstitial lung complications. Pulmonary adverse effects reported after Infliximab include tuberculosis reactivation, invasive aspergillosis, interstitial pneumonitis, pulmonary oedema and alveolar hemorrhage. Aims Four cases previously reported associate Infliximab to eosinophilic pneumonitis. However, this is the first in pediatrics. Methods Case report of an adolescent female with IBD and a rare adverse reaction to Infliximab Results Our patient was diagnosed with ulcerative pancolitis, Mayo 2, initially treated with 5-ASA. Five months into therapy she was switched to azathioprine and Infliximab (10mg/kg every 8 weeks) due to worsening disease. She attained and maintained clinical and biochemical remission for the next 1.5 years. Azathioprine was stopped at the patient’s request. One month later, she presented with cough and nasal congestion but was afebrile. Peripheral eosinophilia was noted. Salbutamol and steroid inhalers were started, without improvement. She was admitted to hospital due to progressive cough, shortness of breath, and wheezing. Physical examination was otherwise unremarkable. Pulmonary function test showed FVC of 69%, FEV1 of 45% with bronchodilator effect of 12% and a FEV1/FVC of 59. Her blood work showed eosinophilia (4.42 x109/L) and an elevated IgE (4596 ug/L). Serum-specific IgE for Aspergillus was positive; but skin testing was negative. An X-ray showed marked bilateral interstitial thickening in the mid and lower zones. Chest CT showed extensive bronchiectasis with bronchial mucous plugging. A bronchoscopy with bronchoalveolar lavage (BAL) reported marked eosinophilia, negative for mycobacterium, bacterial and fungal growth. Other infectious and autoimmune etiologies were ruled out. She responded successfully to high-dose prednisone (50 mg/day). At discharge, symptoms had improved, and her pulmonary function tests were normal (FEV1 of 95% predicted and FEV1/FVC 84). Upon steroid taper, she relapsed in pulmonary symptoms, eosinophilia, as well as a flare of her IBD. Reinduction with steroids resolved her symptoms and eosinophilia. Due to her loss of response to Infliximab and pulmonary, she was switched to Vedolizumab with good response. After stopping Infliximab her lung function improved significantly (FVC of 96% predicted and FEV1 of 98% predicted) and has remained so. Peripheral eosinophilia dropped to 0.2 x109/L. Her IBD is currently in remission without any respiratory symptoms. Conclusions Eosinophilic pneumonitis can be a complication of Infliximab. Our patient had a delayed presentation of respiratory symptoms, 16 months after a satisfactory response to Infliximab. Although responsive to steroids, she ultimately needed to be switched to another immunosuppressive agent. Funding Agencies None

scholarly journals PREVALENCE OF RESPIRATORY SYMPTOMS AND PULMONARY FUNCTION STATUS OF RESTAURANT WORKERS

2020 ◽  
Vol 20 (3) ◽  
pp. 163-172
Author(s):  
Mohammed Abdulrazzaq Jabbar Jabbar ◽  
Retneswari Masilamani ◽  
Lim Zhi Yik ◽  
Chen Pei Fei ◽  
Loh Xin Ni ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Prolonged Exposure ◽  
Respiratory Health ◽  
Pulmonary Function Tests ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Mean Values ◽  
Cooking Fumes

The cooking process may emit toxic compounds and airway irritants from both the fuel combustion and cooking fumes which is harmful to the respiratory health among the restaurant workers. A cross-sectional study of 243 restaurant workers from the selected restaurants in Sungai Long, Malaysia was conducted. The standardized British Medical Research Council questionnaire on Respiratory Symptoms (1986) was used during the interview to access the symptoms and the spirometry test was performed to evaluate the pulmonary functions of the participants. The data of socio-demography and occupational characteristics were also collected. The most complaint respiratory symptoms by the restaurant workers were breathlessness, which accounted for 33.7%, followed by wheezing (14%). The mean values of all pulmonary function tests (PFT) of the restaurant workers were within the normal range (>80%), except for the Peak Expiratory Flow (PEF) (79.09%). The results of the bivariate statistical analysis, Chi-square, ANOVA and t-test, showed the determining factors of the respiratory health among the workers were workers’ age and gender in addition to the working duration and the ethnicity. The restaurant workers in Sungai Long were at risk of developing respiratory symptoms and lower pulmonary function values due to prolonged exposure to cooking fumes. Emphasis should be given to the safety and health of restaurant workers and health education should be provided to the restaurant workers and owners. Strategies to increase notification of such occurrences among these workers should be looked into by related agencies in the country.

Airway reactivity and lung function in triiodothyronine-induced thyrotoxicosis

1985 ◽  
Vol 58 (5) ◽  
pp. 1485-1488 ◽  
Author(s):  
R. S. Irwin ◽  
M. R. Pratter ◽  
D. H. Stivers ◽  
L. E. Braverman
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Base Line ◽  
Airway Reactivity ◽  
Percent Change ◽  
Serum T3 ◽  
The Mean

To evaluate the possible relationship between asthma and hyperthyroidism, airway reactivity and lung function were prospectively compared in healthy volunteers before, during, and after liothyronine (triiodothyronine, T3)-induced hyperthyroidism. Base-line evaluation of the 10 subjects included clinical evaluation, thyroid and pulmonary function tests, and airway reactivity assessed by methacholine inhalational challenge (MIC). All studies were normal. During T3-induced hyperthyroidism, no subject developed respiratory symptoms or changes in pulmonary function or airway reactivity. The mean percent change in forced expiratory volume at 1 s from base line (delta FEV1) of -2.4 +/- 3.0 after MIC was not significantly different from that obtained before T3 administration (-1.4 +/- 1.5, P greater than 0.2). When all serum T3 concentrations and delta FEV1 values before, during and after T3-induced hyperthyroidism were compared, there was no significant correlation. We conclude that T3-induced hyperthyroidism of 3-wk duration has no effect on airway reactivity or lung function in normal volunteers.

scholarly journals The Feasibility of High Dose Iodine 131 Treatment as an Alternative to Surgery in Patients with a Very Large Goiter: Effect on Thyroid Function and Size and Pulmonary Function*

1999 ◽  
Vol 84 (10) ◽  
pp. 3636-3641 ◽  
Author(s):  
Steen J. Bonnema ◽  
Henrik Bertelsen ◽  
Jesper Mortensen ◽  
Peter B. Andersen ◽  
Dorthe U. Knudsen ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Significant Negative Correlation ◽  
Cross Sectional Area ◽  
High Dose ◽  
Sectional Area ◽  
Cross Sectional ◽  
Large Goiter ◽  
Mean Size ◽  
Clinically Significant

Abstract Some patients with very large goiters (>150 mL) are not candidates for surgery. We evaluated the feasibility of high dose 131I in such patients. Twenty-three patients (2 men and 21 women; median age, 67 yr; range, 42–86 yr) with very large goiter (8 toxic) were treated with calculated high dose 131I [median, 2281 megabecquerels (61.6 mCi); range, 988-4620 megabecquerels (26.7–124.9 mCi)]. During the 12-month observation period, goiter reduction and tracheal anatomy were monitored by magnetic resonance imaging, and the respiratory capacity was monitored by pulmonary function tests. Five patients (22%) developed hypothyroidism. Thyroid volumes were at baseline, after 1 week, and after 1 yr [mean ± sem, 311 ± 28, 314 ± 26 (P = NS), and 215 ± 26 (P < 0.01) mL]. The relative changes 1 week after therapy ranged from −14.1% to 15.3%. After 1 yr the mean size was reduced by 33.9% (range, 13.5–61.4%). Only the initial goiter size showed a significant negative correlation to the percent reduction. The smallest cross-sectional area of the trachea decreased 9.2% within 1 week after treatment, but eventually emerged with a 17.9% larger area [mean ± sem, 84.3 ± 4.8, 75.5 ± 5.1 (P < 0.01), and 98.2 ± 6.0 (P < 0.01) mm2]. The inspiratory parameter, FIF50%, improved after an initial insignificant decline[ baseline therapy, after 1 week, after 3 months, and after 1 yr (mean ± sem), 2.37 ± 0.24, 2.20 ± 0.21 (P = NS), 2.51 ± 0.23 (P= NS), and 2.76 ± 0.25 (P = 0.01) L/s]. FIF50% correlated significantly with the smallest cross-sectional tracheal area (baseline, 1 week, and 1 yr: r = 0.74; P < 0.001, r = 0.63; P < 0.005, and r = 0.46; P < 0.05). Changes in tracheal anatomy did not correlate with changes in either lung dynamics or goiter size. In conclusion, very large goiters can be reduced by a third, on the average, with high dose 131I therapy without any initial clinically significant tracheal compression. Tracheal cross-sectional area as well as pulmonary inspiratory capacity improve. No serious adverse effects are seen.

scholarly journals Evaluation of pulmonary function and respiratory symptoms in pyrochlore mine workers

2016 ◽  
Vol 42 (4) ◽  
pp. 279-285 ◽  
Author(s):  
Ritta de Cássia Canedo Oliveira Borges ◽  
José Cerqueira Barros Júnior ◽  
Fabrício Borges Oliveira ◽  
Marisa Andrade Brunherotti ◽  
Paulo Roberto Veiga Quemelo
Keyword(s):  
Occupational Exposure ◽  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Smoking Status ◽  
Pulmonary Function Tests ◽  
Cross Sectional ◽  
Mining Company ◽  
Production Sector ◽  
The Mean ◽  
Mine Workers

ABSTRACT Objective: To identify respiratory symptoms and evaluate lung function in mine workers. Methods: This was a cross-sectional observational study involving production sector workers of a pyrochlore mining company. The subjects completed the British Medical Research Council questionnaire, which is designed to evaluate respiratory symptoms, occupational exposure factors, and smoking status. In addition, they underwent pulmonary function tests with a portable spirometer. Results: The study involved 147 workers (all male). The mean age was 41.37 ± 8.71 years, and the mean duration of occupational exposure was 12.26 ± 7.09 years. We found that 33 (22.44%) of the workers had respiratory symptoms and that 26 (17.69%) showed abnormalities in the spirometry results. However, we found that the spirometry results did not correlate significantly with the presence of respiratory symptoms or with the duration of occupational exposure. Conclusions: The frequencies of respiratory symptoms and spirometric changes were low when compared with those reported in other studies involving occupational exposure to dust. No significant associations were observed between respiratory symptoms and spirometry results.

scholarly journals Observational study of omeprazole for gastroesophageal reflux on pulmonary function in adult asthmatics

2017 ◽  
Vol 9 (2) ◽  
pp. 139-145
Author(s):  
Nattapong Jaimchariyatam ◽  
Phurin Haprasert ◽  
Sutep Gonchanvit ◽  
Somkiat Wongtim
Keyword(s):  
Gastroesophageal Reflux ◽  
Pulmonary Function ◽  
Asthma Control ◽  
Pulmonary Function Tests ◽  
High Dose ◽  
Uncontrolled Asthma ◽  
Act Scores ◽  
Function Tests ◽  
The Mean ◽  
Act Score

Abstract Background Asthma is a chronic inflammatory disease of airways. Gastroesophageal reflux disease (GERD) is known to be associated with worsening asthma. We hypothesized that treatment of GERD in asthmatics will improve asthma control and quality of life. We reviewed our experience of treatment of GERD in asthmatics in Thailand. Objectives To study the effects of omeprazole for treatment of GERD in patients with poorly controlled asthma on pulmonary function tests and asthma control test (ACT) scores. Methods This study was conducted at King Chulalongkorn Memorial Hospital between August 2009 and December 2010. Patients with partly controlled and uncontrolled asthma who were found to have GERD by 24 hour esophageal pH monitoring were administered omeprazole 40 mg per day for 8 weeks. Pulmonary function tests and ACT scores before and after treatment were compared at 4-weeks and 8-weeks follow up. Results Twenty four patients were included in this study. None of them had asthmatic attacks during the study. After 4 and 8 weeks of omeprazole treatment, the mean FEV1 (2.20 ± 0.64 L, 2.36 ± 0.58 L, respectively) and the mean ACT score (20.82 ± 3.30, 23.00 ± 1.69, respectively) were significantly higher than the pretreatment values (mean FEV1 1.99 ± 0.56 L and ACT score 16.36 ± 3.97) (P < 0.05). Conclusion High-dose omeprazole may improve pulmonary function and the level of asthma control in Thai patients with partly controlled or uncontrolled asthma and coexisting GERD.

scholarly journals Respiratory symptoms and pulmonary function tests in school teachers of Shimla

Lung India ◽  
2007 ◽  
Vol 24 (1) ◽  
pp. 6 ◽  
Author(s):  
S Kashyap ◽  
A Sharma ◽  
D Gupta ◽  
PR Mohapatra ◽  
P Vaidya
Keyword(s):  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Pulmonary Function Tests ◽  
School Teachers ◽  
Function Tests
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