Feather duvet lung

A 43-year-old non-smoker was referred with a 3-month history of malaise, fatigue and breathlessness. Blood avian precipitins were strongly positive. Lung function testing confirmed a restrictive pattern with impaired gas transfer. A ‘ground glass’ mosaic pattern was seen on CT imaging, suggestive of hypersensitivity pneumonitis. Although he had no pet birds, on closer questioning he had recently acquired a duvet and pillows containing feathers. His symptoms, chest radiograph and lung function tests improved after removal of all feather bedding, and he was also started on oral corticosteroid therapy. Our case reinforces the importance of taking a meticulous exposure history and asking about domestic bedding in patients with unexplained breathlessness. Prompt recognition and cessation of antigen exposure may prevent the development of irreversible lung fibrosis.

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The Global Lung Function Initiative (GLI) Network: bringing the world’s respiratory reference values together

Breathe ◽

10.1183/20734735.012717 ◽

2017 ◽

Vol 13 (3) ◽

pp. e56-e64 ◽

Cited By ~ 32

Author(s):

Brendan G. Cooper ◽

Janet Stocks ◽

Graham L. Hall ◽

Bruce Culver ◽

Irene Steenbruggen ◽

...

Keyword(s):

Lung Function ◽

Reference Values ◽

Age Groups ◽

Data Repository ◽

Gas Transfer ◽

List Type ◽

Lung Function Testing ◽

Recent Developments ◽

Reference Equations ◽

Function Testing

The Global Lung Function Initiative (GLI) Network has become the largest resource for reference values for routine lung function testing ever assembled. This article addresses how the GLI Network came about, why it is important, and its current challenges and future directions. It is an extension of an article published inBreathein 2013 [1], and summarises recent developments and the future of the GLI Network.Key pointsThe Global Lung Function Initiative (GLI) Network was established as a result of international collaboration, and altruism between researchers, clinicians and industry partners. The ongoing success of the GLI relies on network members continuing to work together to further improve how lung function is reported and interpreted across all age groups around the world.The GLI Network has produced standardised lung function reference values for spirometry and gas transfer tests.GLI reference equations should be adopted immediately for spirometry and gas transfer by clinicians and physiologists worldwide.The recently established GLI data repository will allow ongoing development and evaluation of reference values, and will offer opportunities for novel research.Educational aimsTo highlight the advances made by the GLI Network during the past 5 years.To highlight the importance of using GLI reference values for routine lung function testing (e.g. spirometry and gas transfer tests).To discuss the challenges that remain for developing and improving reference values for lung function tests.

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The effects of oral corticosteroid treatment (OCS) on sequential lung function tests in a cohort of patients with acute hypersensitivity pneumonitis (AHP)

10.1183/13993003.congress-2020.3479 ◽

2020 ◽

Author(s):

Abhinav Tiwari ◽

Vanessa Titmuss ◽

Suresh Babu ◽

Anna Donaldson

Keyword(s):

Lung Function ◽

Hypersensitivity Pneumonitis ◽

Oral Corticosteroid ◽

Corticosteroid Treatment ◽

Lung Function Tests ◽

Function Tests

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Natural history of lung function over one year in patients with Parkinson's disease

Respiratory Medicine ◽

10.1016/j.rmed.2021.106396 ◽

2021 ◽

Vol 182 ◽

pp. 106396

Author(s):

David A. Kaminsky ◽

Donald G. Grosset ◽

Deena M. Kegler-Ebo ◽

Salvador Cangiamilla ◽

Michael Klingler ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Lung Function ◽

Natural History ◽

History Of ◽

One Year

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Lung function testing

Current Paediatrics ◽

10.1016/s0957-5839(05)80051-x ◽

1993 ◽

Vol 3 (2) ◽

pp. 92-95

Author(s):

P. Helms

Keyword(s):

Lung Function ◽

Lung Function Testing ◽

Function Testing

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Irreversible Lung Function Deficits in Young Adults With a History of Childhood Asthma

PEDIATRICS ◽

10.1542/peds.2007-0846tt ◽

2007 ◽

Vol 120 (Supplement 3) ◽

pp. S128.1-S128

Author(s):

Timothy Andrews ◽

James R. Banks

Keyword(s):

Young Adults ◽

Lung Function ◽

Childhood Asthma ◽

History Of Childhood ◽

History Of

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Colchicine Therapy in Sarcoid Arthropathy

PEDIATRICS ◽

10.1542/peds.78.4.717 ◽

1986 ◽

Vol 78 (4) ◽

pp. 717-718

Author(s):

ISRAEL RUBINSTEIN ◽

GERALD L. BAUM

Keyword(s):

Oral Corticosteroid ◽

Bed Rest ◽

Dramatic Improvement ◽

Adequate Response ◽

Limited Success ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Oral Corticosteroid Therapy ◽

Low Dosage ◽

Colchicine Therapy

To the Editor.— We read with great interest the article by Lindsley and Godfrey1 but wish to disagree with one of their conclusions. They suggested that oral corticosteroid therapy is the treatment of choice in sarcoid arthropathy because salicylate and other nonsteroidal anti-inflammatory drugs have only limited success in such cases. We believe, however, that this is not the case, because low-dosage colchicine therapy has provided good results in the agement of both the acute and chronic forms of sarcoid arthropathy when there was no adequate response to nonsteroidal anti-inflammatory agents and bed rest. Colchicine was first used in the treatment of sarcoid arthropathy by Kaplan,2,3 who reported a dramatic improvement, usually within a few days, with the use of 0.5 mg of oral colchicine daily. Subsequently, maintenance oral therapy with colchicine, 1 to 2 mg/d, was introduced to treat the chronic form of the disease, with similar beneficial results.3-7

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Idiopathic subglottic stenosis in a young female patient

BMJ Case Reports ◽

10.1136/bcr-2020-241525 ◽

2021 ◽

Vol 14 (5) ◽

pp. e241525

Author(s):

Benjamin Pomerantz ◽

Michael Pomerantz ◽

Arkadiy Finn

Keyword(s):

Balloon Dilatation ◽

Young Female ◽

Rigid Bronchoscopy ◽

Pulmonary Function Testing ◽

Subglottic Stenosis ◽

Productive Cough ◽

Shortness Of Breath ◽

History Of ◽

One Year ◽

Function Testing

A previously healthy 30-year-old woman presented with 3 years of progressive shortness of breath and audible wheezing. One year prior to presentation, she developed a chronic non-productive cough. Pulmonary function testing revealed flattened inspiratory and expiratory peaks, characteristic of an extrathoracic fixed tracheal obstruction. Bronchoscopy confirmed subglottic stenosis (SGS). She had no history of intubation, tracheostomy or evidence of a systemic inflammatory illness. She was diagnosed with idiopathic SGS and referred for rigid bronchoscopy with balloon dilatation resulting in improvement in her symptoms.

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Reduction in TLco and survival in a clinical population

European Respiratory Journal ◽

10.1183/13993003.02046-2020 ◽

2021 ◽

pp. 2002046

Author(s):

Martin Raymond Miller ◽

Brendan G. Cooper

Keyword(s):

Lung Function ◽

Cox Regression ◽

Clinical Population ◽

European Ancestry ◽

Grading System ◽

Gas Transfer ◽

Ethnic Bias ◽

All Cause Mortality ◽

Z Scores ◽

Survival Risk

How best to express the level of lung gas transfer (TLco) function has not been properly explored. We used the most recent clinical data from 13 829 patients (54% male, 10% non-European ancestry), median age 60.5 years (range 20–97), median survival 3.5 years (range 0–20) to determine how best to express TLco function in terms of its relation to survival. The proportion of subjects of non-European ancestry with Global Lung Function Initiative (GLI) TLco z-scores above predicted was reduced but was significantly increased between −1.5 to −3.5 suggesting the need for ethnicity appropriate equations. Applying GLI FVC ethnicity methodology to GLI TLco z-scores removed this ethnic bias and was used for all subsequent analysis. TLco z-scores using the GLI equations were compared with Miller's US equations with median TLco z-scores being -1.43 and -1.50 for GLI and Miller equations respectively (interquartile range −2.8 to −0.3 and −2.4 to −0.7, respectively). GLI TLco z-scores gave the best Cox regression model for predicting survival. A previously proposed six-tier grading system for level of lung function did not show much separation in survival risk in the less severe grades. A new four-tier grading based on z-scores of −1.645, −3 and −5 showed better separation of risk with hazard ratio for all-cause mortality of 2.0, 3.4 and 6.6 with increasing severity. Using GLI FVC ethnicity methodology to GLI TLco predictions removed ethnic bias and may be the best approach until relevant datasets are available.

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Outcomes of immunosuppressive therapy in chronic hypersensitivity pneumonitis

ERJ Open Research ◽

10.1183/23120541.00016-2017 ◽

2017 ◽

Vol 3 (3) ◽

pp. 00016-2017 ◽

Cited By ~ 24

Author(s):

Ayodeji Adegunsoye ◽

Justin M. Oldham ◽

Evans R. Fernández Pérez ◽

Mark Hamblin ◽

Nina Patel ◽

...

Keyword(s):

Mycophenolate Mofetil ◽

Lung Function ◽

Adverse Events ◽

Immunosuppressive Therapy ◽

Hypersensitivity Pneumonitis ◽

Pulmonary Function Tests ◽

Lung Function Decline ◽

Azathioprine Therapy ◽

Free Survival ◽

Chronic Hypersensitivity Pneumonitis

In chronic hypersensitivity pneumonitis (CHP), lack of improvement or declining lung function may prompt use of immunosuppressive therapy. We hypothesised that use of azathioprine or mycophenolate mofetil with prednisone reduces adverse events and lung function decline, and improves transplant-free survival.Patients with CHP were identified. Demographic features, pulmonary function tests, incidence of treatment-emergent adverse events (TEAEs) and transplant-free survival were characterised, compared and analysed between patients stratified by immunosuppressive therapy. A multicentre comparison was performed across four independent tertiary medical centres.Among 131 CHP patients at the University of Chicago medical centre (Chicago, IL, USA), 93 (71%) received immunosuppressive therapy, and had worse baseline forced vital capacity (FVC) and diffusing capacity, and increased mortality compared with those who did not. Compared to patients treated with prednisone alone, TEAEs were 54% less frequent with azathioprine therapy (p=0.04) and 66% less frequent with mycophenolate mofetil (p=0.002). FVC decline and survival were similar between treatment groups. Analyses of datasets from four external tertiary medical centres confirmed these findings.CHP patients who did not receive immunosuppressive therapy had better survival than those who did. Use of mycophenolate mofetil or azathioprine was associated with a decreased incidence of TEAEs, and no difference in lung function decline or survival when compared with prednisone alone. Early transition to mycophenolate mofetil or azathioprine may be an appropriate therapeutic approach in CHP, but more studies are needed.

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