scholarly journals Change in serum KL-6 level from baseline is useful for predicting life-threatening EGFR-TKIs induced interstitial lung disease

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Shigeo Kawase ◽  
Noboru Hattori ◽  
Nobuhisa Ishikawa ◽  
Yasushi Horimasu ◽  
Kazunori Fujitaka ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Life Threatening ◽  
Egfr Tkis

scholarly journals Fast-Onset Diffuse Interstitial Lung Disease in Anti-MDA5 Antibodies-Associated Amyopathic Dermatomyositis

2021 ◽  
Vol 11 (2) ◽  
pp. 235-240
Author(s):  
Houari Aissaoui ◽  
Kinan Drak Alsibai ◽  
Naji Khayath
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Distress Syndrome ◽  
Early Stage ◽  
Immunosuppressive Treatment ◽  
Amyopathic Dermatomyositis ◽  
Pulmonary Manifestations ◽  
Life Threatening ◽  
Adequate Management ◽  
Chest Ct Scan

Anti-MDA5 antibodies-associated amyopathic dermatomyositisis a rare autoimmune disease that involve polyarthritis, cutaneous and pulmonary manifestations. The development of rapidly progressing interstitial lung disease is a life-threatening complication. We report the case of a 45-year-old woman without medical history, who was addressed to the Pulmonary Department for a polyarthritis with dry cough and hypoxemic dyspnea. Initially there was neither cutaneous manifestation nor interstitial lung disease on chest CT scan. After a few days, the patient developed fatal acute respiratory failure with diffuse ground glass opacities. Identification of anti-MDA5 antibodies allowed establishing diagnosis, despite the fact that the first immunological assessment was negative. Corticosteroid bolus of 1 g for three days and immunosuppressive treatment by cyclophosphamide was only initiated at the acute respiratory distress syndrome stage. Given the rapidly unfavorable prognosis of this entity of amyopathic dermatomyositis, the testing for anti-MDA5 antibodies should be recommended in case of progressive pulmonary symptoms associated with joint signs in order to identify this disease at an early stage and to begin rapid and adequate management.

scholarly journals Bi-lung transplantation in anti-synthetase syndrome with life-threatening interstitial lung disease

Rheumatology ◽  
2018 ◽  
Vol 57 (9) ◽  
pp. 1688-1689 ◽  
Author(s):  
Marion Delplanque ◽  
Marc Gatfosse ◽  
Hafid Ait-Oufella ◽  
Olaf Mercier ◽  
Laurent Savale ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Transplantation ◽  
Lung Disease ◽  
Life Threatening

Life-threatening interstitial lung disease associated with trastuzumab: case report

2008 ◽  
Vol 113 (3) ◽  
pp. 609-612 ◽  
Author(s):  
M. J. Pepels ◽  
K. A. Boomars ◽  
R. van Kimmenade ◽  
P. S. Hupperets
Keyword(s):  
Case Report ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Life Threatening

scholarly journals Pre-existing interstitial lung disease is associated with onset of nivolumab-induced pneumonitis in patients with solid tumors: A retrospective analysis

2019 ◽  
Author(s):  
Teppei Yamaguchi ◽  
Junichi Shimizu ◽  
Takaaki Hasegawa ◽  
Yoshitsugu Horio ◽  
Yoshitaka Inaba ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Solid Tumors ◽  
Odds Ratio ◽  
Malignant Tumors ◽  
Checkpoint Inhibitors ◽  
Patient Characteristics ◽  
Chest Ct ◽  
Life Threatening ◽  
Male Sex

Abstract BackgroundNivolumab, an anti-programmed death 1 (PD-1) monoclonal antibody, has shown survival benefit in clinical trials of various malignant tumors. Nivolumab-induced pneumonitis is major immune-related adverse event (irAE) that is occasionally serious and life-threatening. The aim of this study was to examine the association between pre-existing interstitial lung disease (ILD) on chest computed tomography (CT) and nivolumab-induced pneumonitis among different types of solid tumors.MethodsWe retrospectively collected the clinical data of 311 patients who were diagnosed with non-small cell lung cancer (NSCLC), head and neck cancer (HNC), or gastric cancer (GC), and treated with nivolumab monotherapy. Patients who underwent chest CT immediately before starting nivolumab without previous thoracic radiotherapy or other immune checkpoint inhibitors were eligible. We collected baseline patient characteristics and assessed pre-existing ILD on baseline chest CT.ResultsFinally, 188 patients were included in the analysis: 96 patients with NSCLC, 43 patients with HNC, and 49 patients with GC. NSCLC patients had a significantly higher rate of pre-existing ILD compared with HNC/GC patients (P=0.047). Nivolumab-induced pneumonitis occurred in 11.7% (22 of 188), including 14.6% (14 of 96) of NSCLC, and 8.7% (8 of 92) of HNC/GC. Univariate and multivariate logistic regression analyses revealed that pre-existing ILD (odds ratio, 5.92; 95% confidence interval (CI), 2.07–18.54, P=0.0008) and male sex (odds ratio, 5.58; 95% CI, 1.01–104.40, P=0.049) significantly increased the risk of nivolumab-induced pneumonitis.ConclusionOur results indicated that pre-existing ILD and male sex are risk factors for nivolumab-induced pneumonitis in solid tumors.

Krebs Von Den Lungen-6 (KL-6) Is A Useful Biomarker For Life-Threatening EGFR-TKI Related Interstitial Lung Disease

2011 ◽  
Author(s):  
Shigeo Kawase ◽  
Noboru Hattori ◽  
Nobuhisa Ishikawa ◽  
Yasushi Horimasu ◽  
Osamu Furonaka ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Life Threatening ◽  
Egfr Tki

scholarly journals Use of ruxolitinib in COPA syndrome manifesting as life-threatening alveolar haemorrhage

Thorax ◽  
2019 ◽  
Vol 75 (1) ◽  
pp. 92-95 ◽  
Author(s):  
Marie-Louise Frémond ◽  
Marie Legendre ◽  
Michael Fayon ◽  
Annick Clement ◽  
Emilie Filhol-Blin ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
T Lymphocytes ◽  
Lung Disease ◽  
Renal Dysfunction ◽  
Unknown Origin ◽  
Alveolar Haemorrhage ◽  
Healthy Controls ◽  
Functional Tests ◽  
Life Threatening ◽  
Copa Syndrome

COPA (coatomer subunit α) syndrome is a newly recognised cause of interstitial lung disease in children and adults, frequently associated with arthritis and renal dysfunction. We report a 11-year-old girl with disease limited to major pulmonary haemosiderosis manifesting at the age of 2 years, due to a heterozygous p.(Arg233His) mutation in COPA. Her interferon (IFN) signature was elevated (10.312 and 12.429, healthy <2.466), as was the level of serum IFNα (211 fg/mL, healthy <10 fg/mL). STAT1 phosphorylation in T lymphocytes and monocytes was increased as compared with healthy controls. Based on these results she was treated with the JAK1/2 inhibitor ruxolitinib, which resulted in reduction in IFN signalling and appeared to be associated with partial though incomplete decrease in the severity of her pulmonary disease. Patients with alveolar haemorrhage of unknown origin should be considered for COPA screening. Functional tests can help to personalise patient therapy.

scholarly journals Prognostic impact of pre-existing interstitial lung disease in non-HIV patients with Pneumocystis pneumonia

2020 ◽  
Vol 6 (2) ◽  
pp. 00306-2019
Author(s):  
Shohei Hamada ◽  
Hidenori Ichiyasu ◽  
Megumi Inaba ◽  
Hiroshi Takahashi ◽  
Tomoki Sadamatsu ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Serum Levels ◽  
Lavage Fluid ◽  
Pneumocystis Pneumonia ◽  
Lower Percentage ◽  
Prognostic Impact ◽  
Life Threatening

BackgroundThe increasing incidence of life-threatening Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients is a global concern. Yet, no reports have examined the prognostic significance of pre-existing interstitial lung disease (ILD) in non-HIV PCP.MethodsWe retrospectively reviewed the medical records of non-HIV PCP patients with (ILD group) or without (non-ILD group) pre-existing ILD. The clinical features and outcomes of the ILD group were compared with those of the non-ILD group. Cox regression models were constructed to identify prognostic factors.Results74 patients were enrolled in this study. The 90-day mortality was significantly higher in the ILD group than in the non-ILD group (62.5% versus 19.0%, p<0.001). In the ILD group, patients with a higher percentage of bronchoalveolar lavage fluid neutrophils had worse outcomes compared to those having a lower percentage (p=0.026). Multivariate analyses revealed that pre-existing ILD (p=0.002) and low levels of serum albumin (p=0.009) were independent risk factors for 90-day mortality. Serum levels of β-d-glucan were significantly reduced after treatment of PCP in both groups, whereas levels of Krebs von den Lungen-6 (KL-6) significantly increased in the ILD group. In the ILD group, the 90-day mortality of patients with increasing KL-6 levels after treatment was significantly higher than those with decreasing levels (78.9% versus 0%, p=0.019).ConclusionIn non-HIV PCP patients, pre-existing ILD is associated with a poorer prognosis. Prophylaxis for PCP is needed in patients with pre-existing ILD under immunosuppression.

Endovascular Treatment of Multiple Bronchial Artery Aneurysms With Prominent Fistula to Pulmonary Artery in a Patient With Interstitial Lung Disease: A Case Report and Literature Review

2019 ◽  
Vol 53 (6) ◽  
pp. 492-496
Author(s):  
Yuan Li ◽  
Guang-Chao Gu ◽  
Bao Liu ◽  
Jiang Shao ◽  
Yu Chen ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Bronchial Artery ◽  
Pulmonary Arteries ◽  
Artery Aneurysm ◽  
Transcatheter Embolization ◽  
Life Threatening ◽  
Nontarget Embolization ◽  
Feeding Vessels ◽  
The Right

Bronchial artery aneurysm (BAA) is a rare entity. Ruptured BAA can cause life-threatening hemorrhage. It is recommended that treatment should be initiated immediately after diagnosis. We present the case of a 56-year-old female with multiple BAAs and interstitial lung disease. Aortic computed tomography angiography demonstrated that the largest aneurysm at the right hilum was fed by right subclavian artery and right bronchial artery. A fistula between the pulmonary trunk and the aneurysm was also revealed. The patient underwent transcatheter embolization. Coils were placed in the feeding vessels instead of the aneurysms to avoid nontarget embolization of the pulmonary arteries through the fistula. The procedure achieved reduction in aneurysmal blood flow. The patient’s cough resolved at 6-month follow-up.

scholarly journals Anti-SAE1 Antibodies and Dermatomyositis: A Case Series of Three Patients

2020 ◽  
Vol 4 (6) ◽  
pp. 578-584
Author(s):  
Claire Wilson ◽  
Brandon Roman ◽  
Kurt Ashack ◽  
Iris K Aronson
Keyword(s):  
Interstitial Lung Disease ◽  
Cohort Studies ◽  
Lung Disease ◽  
Patient Population ◽  
Case Series ◽  
Response To Treatment ◽  
Laboratory Findings ◽  
Cutaneous Manifestations ◽  
Associated Symptoms ◽  
Life Threatening

To date, few patients with anti-SAE1 dermatomyositis (DM) have been described, and usually in large descriptive cohort studies including all DM subtypes. Thus, it is increasingly important to further describe this rare subtype to solidify cutaneous findings, associated symptoms, and potential therapeutic options. Herein, this case series describes three patients with anti-SAE1 DM with respect to their clinical and laboratory findings, and also their response to treatment. All three patients eventually presented with classic cutaneous manifestations of dermatomyositis, however, Case 2 presented initially with cutaneous manifestations not described in the literature. Furthermore, two patients presented with dysphagia, with Case 2 experiencing a life-threatening dysphagia not typically described in the literature. Two of three patients also presented with early signs of interstitial lung disease. Lastly, cutaneous disease was only responsive to immunosuppressants in one patient. Unfortunately, this observational case-series consisted of only three patients, limiting the generalizability of our results. However, this study provides further support of the recalcitrant nature of this DM subtype, and commonly affected extracutaneous systems including the gastrointestinal and pulmonary systems. Larger studies of this patient population are needed to further confirm our associated findings. 

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