scholarly journals Hypersensitivity pneumonitis – acceptance of the diagnosis

Pneumologia ◽  
2021 ◽  
Vol 69 (3) ◽  
pp. 186-189
Author(s):  
Patricia Hogea ◽  
Emanuela Tudorache ◽  
Zsolt Vastag ◽  
Andrada Gârjoabă ◽  
Cristian Oancea
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
High Resolution Computed Tomography ◽  
Serological Tests ◽  
Exertional Dyspnea ◽  
The Past ◽  
Repetitive Exposure ◽  
Etiological Agents ◽  
Pigeon Breeder ◽  
Organic Particles ◽  
Hypersensitivity Pneumonia

Abstract Hypersensitivity pneumonia (HP) is an inflammatory lung syndrome due to repetitive exposure to small organic particles. The etiological agents of the disease are diverse and can be represented by fungi, bacteria, small molecule chemical compounds, as well as proteins from animals or insects. We present the case of a 25-year-old male, who was admitted to our Pulmonology Clinic for the following symptoms: morning cough with mucosal sputum for about 2 years, moderate exertional dyspnea (mMRC 3) started for 2 months, weight loss of about 6 kg in the past 5 months and fatigue. Clinical examination revealed bilateral mid- basal crackling rales. Chest high-resolution computed tomography (HRCT) (multiple micronodular opacities, diffuse contoured, bilaterally disseminated), lung function tests (restrictive ventilatory dysfunction with decreased carbon monoxide diffusing capacity), bronchoalveolar lavage (BAL) (lymphocyte alveolitis) and serological tests (positive antibodies for pigeon heathers and dejections) pointed to the diagnosis of hypersensitivity pneumonitis. It was recommended to avoid exposure to pigeons, as the patient was a pigeon breeder. Prednisone treatment was initiated. The general condition of the patient 1 month after diagnosis had improved, the evolution being good under treatment.

scholarly journals High-resolution computed tomography and histopathological findings in hypersensitivity pneumonitis: a pictorial essay

2016 ◽  
Vol 49 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Pedro Paulo Teixeira e Silva Torres ◽  
Marise Amaral Rebouças Moreira ◽  
Daniela Graner Schuwartz Tannus Silva ◽  
Roberta Rodrigues Monteiro da Gama ◽  
Denis Masashi Sugita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Biopsy ◽  
Hypersensitivity Pneumonitis ◽  
Giant Cells ◽  
Clinical Findings ◽  
High Resolution Computed Tomography ◽  
Histopathological Findings ◽  
Pictorial Essay ◽  
Inflammatory Infiltrates

Abstract Hypersensitivity pneumonitis is a diffuse interstitial and granulomatous lung disease caused by the inhalation of any one of a number of antigens. The objective of this study was to illustrate the spectrum of abnormalities in high-resolution computed tomography and histopathological findings related to hypersensitivity pneumonitis. We retrospectively evaluated patients who had been diagnosed with hypersensitivity pneumonitis (on the basis of clinical-radiological or clinical-radiological-pathological correlations) and had undergone lung biopsy. Hypersensitivity pneumonitis is clinically divided into acute, subacute, and chronic forms; high-resolution computed tomography findings correlate with the time of exposure; and the two occasionally overlap. In the subacute form, centrilobular micronodules, ground-glass opacities, and air trapping are characteristic high-resolution computed tomography findings, whereas histopathology shows lymphocytic inflammatory infiltrates, bronchiolitis, variable degrees of organizing pneumonia, and giant cells. In the chronic form, high-resolution computed tomography shows traction bronchiectasis, honeycombing, and lung fibrosis, the last also being seen in the biopsy sample. A definitive diagnosis of hypersensitivity pneumonitis can be made only through a multidisciplinary approach, by correlating clinical findings, exposure history, high-resolution computed tomography findings, and lung biopsy findings.

scholarly journals Myasthenia Gravis: Autoantibody Specificities and Their Role in MG Management

2020 ◽  
Vol 11 ◽  
Author(s):  
Konstantinos Lazaridis ◽  
Socrates J. Tzartos
Keyword(s):  
Neuromuscular Junction ◽  
Myasthenia Gravis ◽  
Clinical Manifestations ◽  
Density Lipoprotein ◽  
Disease Diagnosis ◽  
Autoimmune Response ◽  
Response To Treatment ◽  
Antibody Detection ◽  
Serological Tests ◽  
The Past

Myasthenia gravis (MG) is the most common autoimmune disorder affecting the neuromuscular junction, characterized by skeletal muscle weakness and fatigability. It is caused by autoantibodies targeting proteins of the neuromuscular junction; ~85% of MG patients have autoantibodies against the muscle acetylcholine receptor (AChR-MG), whereas about 5% of MG patients have autoantibodies against the muscle specific kinase (MuSK-MG). In the remaining about 10% of patients no autoantibodies can be found with the classical diagnostics for AChR and MuSK antibodies (seronegative MG, SN-MG). Since serological tests are relatively easy and non-invasive for disease diagnosis, the improvement of methods for the detection of known autoantibodies or the discovery of novel autoantibody specificities to diminish SN-MG and to facilitate differential diagnosis of similar diseases, is crucial. Radioimmunoprecipitation assays (RIPA) are the staple for MG antibody detection, but over the past years, using cell-based assays (CBAs) or improved highly sensitive RIPAs, it has been possible to detect autoantibodies in previously SN-MG patients. This led to the identification of more patients with antibodies to the classical antigens AChR and MuSK and to the third MG autoantigen, the low-density lipoprotein receptor-related protein 4 (LRP4), while antibodies against other extracellular or intracellular targets, such as agrin, Kv1.4 potassium channels, collagen Q, titin, the ryanodine receptor and cortactin have been found in some MG patients. Since the autoantigen targeted determines in part the clinical manifestations, prognosis and response to treatment, serological tests are not only indispensable for initial diagnosis, but also for monitoring treatment efficacy. Importantly, knowing the autoantibody profile of MG patients could allow for more efficient personalized therapeutic approaches. Significant progress has been made over the past years toward the development of antigen-specific therapies, targeting only the specific immune cells or autoantibodies involved in the autoimmune response. In this review, we will present the progress made toward the development of novel sensitive autoantibody detection assays, the identification of new MG autoantigens, and the implications for improved antigen-specific therapeutics. These advancements increase our understanding of MG pathology and improve patient quality of life by providing faster, more accurate diagnosis and better disease management.

Hypersensitivity pneumonitis

2021 ◽  
Vol 31 (1) ◽  
pp. 88-99
Author(s):  
S. N. Avdeev
Keyword(s):  
Immune Response ◽  
Clinical Picture ◽  
Lung Biopsy ◽  
Hypersensitivity Pneumonitis ◽  
Common Finding ◽  
High Resolution Computed Tomography ◽  
Air Trapping ◽  
Wide Range ◽  
Inflammatory Immune Response ◽  
Lungs And Airways

Hypersensitivity pneumonitis (HP) is an inflammatory disease of the lungs and airways that develops in response to repeated inhalation of a wide range of aerosol antigens. The clinical picture and course of HP are highly variable and depend on such factors as the nature of the antigen, the intensity and duration of exposure to the antigen, as well as on the characteristics of the patient's immune response. The annual incidence of HAP is 1.28 -1.94 cases per 100 000. Currently, the diagnosis of HP is usually based on the characteristic clinical picture, high-resolution computed tomography (HRCT) data, bronchoscopy, lung biopsy, and evidence on the antigen. HRCT plays a central role in the diagnosis of HP. The most common finding on HRCT in HP is ground-glass opacities, which can be associated with centrilobular nodules and air trapping. In some cases, the fibrotic HP signs are very similar to those of idiopathic pulmonary fibrosis (IPF), and most changes are found in the lower regions and subpleurally. Therapy for HP usually includes avoiding exposure to the antigen, considering corticosteroids (CS) and/or immunosuppressive therapy to suppress the active inflammatory/immune response, and treating comorbidities. Nintedanib therapy in patients with progressive fibrotic HP results in a slower decline of lung function compared to placebo.

scholarly journals Hypersensitivity Pneumonitis Associated with Red-Vented Bulbul: A New Encounter of Bird Related Hypersensitivity Pneumonitis

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
W. D. N. L. Amarasinghe ◽  
R. Jayasekara ◽  
B. D. W. Jayamanne ◽  
T. D. K. Nalaka ◽  
W. A. D. L. Amarasiri ◽  
...  
Keyword(s):  
Urban Areas ◽  
Lung Biopsy ◽  
Hypersensitivity Pneumonitis ◽  
Close Contact ◽  
High Resolution Computed Tomography ◽  
Female Case ◽  
Severe Reduction ◽  
Chest Clinic ◽  
Oral Corticosteroids ◽  
Good Improvement

Bird related hypersensitivity pneumonitis (HP) is becoming more common than other forms of HP around the world. We present two cases of HP, associated with exposure to visiting birds which had nested within their homes in semi urban areas of Colombo, Sri Lanka. A 65-year-old female (case 1) and a 61-year-old male (case 2) presented to the chest clinic complaining of gradually progressive and persistent chronic dry cough and dyspnoea during the year 2018. Both were found to have close contact with red-vented bulbuls (Konda kurulla) in their homes for more than 6 months prior to onset of symptoms and denied any other risk exposures in detail history taking. In both patients, high-resolution computed tomography chest (HRCT) showed centrilobular nodules of ground glass density with significant lobular air trapping. Video-assisted thoracoscopic (VATs) lung biopsy of case 1 showed patchy and focal interstitial thickening with lymphocytic infiltrate, minimal fibrosis, and few noncaseating granulomata within the interstitium. Transbronchial lung biopsy of case 2 showed thickened alveolar septae with lympho-histiocytic infiltrate and occasional neutrophils and eosinopils. Both showed severe reduction in forced vital capacity (FVC) at presentation. Multidisciplinary diagnosis of HP associated with red-vented bulbuls was made. Both achieved good improvement in clinical, lung function, and radiological assessment following removal of offending antigen exposure and treatment with oral corticosteroids.

scholarly journals Hypersensitivity Pneumonitis with Normal High Resolution Computed Tomography Scans

2001 ◽  
Vol 8 (2) ◽  
pp. 98-101 ◽  
Author(s):  
Farah J Nasser-Sharif ◽  
Meyer S Balter
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lupus Erythematosus ◽  
Hypersensitivity Pneumonitis ◽  
Pulmonary Function Tests ◽  
Open Lung Biopsy ◽  
Ct Scans ◽  
High Resolution Computed Tomography ◽  
High Resolution Ct ◽  
History Of

A case of symptomatic hypersensitivity pneumonitis with normal high resolution computed tomography (CT) scans is presented. The patient, a 32-year-old man with systemic lupus erythematosus, had a chronic, progressive history of respiratory symptoms, abnormal findings on examination and abnormal pulmonary function tests but normal high resolution CT scans of the chest. Diagnosis was made through open lung biopsy. Clinical improvement was seen on removal of the offending antigen. The literature on the utility of high resolution CT scans in hypersensitivity pneumonitis is reviewed.

scholarly journals A clinico etiological study of balanoposthitisin male patients attending the sexual transmitted diseases outpatient department

2019 ◽  
Vol 5 (1) ◽  
pp. 123
Author(s):  
K. Deepa ◽  
C. L. Chitra ◽  
R. Manipriya
Keyword(s):  
Systemic Disease ◽  
Yeast Cells ◽  
Study Group ◽  
Common Complication ◽  
Predisposing Factor ◽  
The Past ◽  
Wet Mount ◽  
Etiological Study ◽  
Male Patients ◽  
Etiological Agents

<p class="abstract"><strong>Background:</strong> The term balanoposthitis refers to inflammation of the glans and the prepuce. It is a widespread condition in male patients attending the genitor-urinary clinic. It may be acute or chronic, occurring most commonly in the uncircumcised men. The aim of the study was to study the incidence of balanoposthitis in all male, to identify the etiological agents by microbiological investigations and the risk factors and the complications associated with balanoposthitis.</p><p class="abstract"><strong>Methods:</strong> Study group consists of 100 male patients presenting with the complaints of pain, pruritus, fissuring of the prepuce and subpreputial discharge attending the STD department were chosen. The detailed history was taken, and clinical examination was done. The subpreputial discharge was collected, and wet mounts, cultures, and subcultures were done.<strong></strong></p><p class="abstract"><strong>Results:</strong> All the patients in the study group with balanoposthitis were uncircumcised. 55% of the patients had some associated systemic disease. Out of the 55 patients, diabetes was present in 45 patients. Of the 51 patients of diabetics, 77.77% were in the recently diagnosed group within the past 5 years. Phimosis and preputial adhesions were the most common complications. The Sensitivity of the KOH wet mount in detecting yeast cells was around 93%. Candida albicans was grown by 56%. In our study, <em>S. aureus</em> (24%) was the most common bacterium isolated.</p><p class="abstract"><strong>Conclusions:</strong> The most common systemic association and the predisposing factor was diabetes mellitus. The infective etiological agents were associated with the majority of balanoposthitis. The most common complication associated with balanoposthitis was phimosis.</p>

scholarly journals A clinical case of idiopathic pulmonary fibrosis against the background of comorbid pathology

2021 ◽  
Vol 20 (3) ◽  
pp. 225-232
Author(s):  
A. V. Teteneva ◽  
V. V. Kalyuzhin ◽  
G. M. Chernyavskaya ◽  
I. D. Bespalova ◽  
G. E. Chernogoryuk ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Clinical Case ◽  
Clinical Laboratory ◽  
Diagnostic Algorithm ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Antifibrotic Therapy ◽  
The Past ◽  
Tomsk Region

Idiopathic pulmonary fibrosis (IPF) is one of the most common diseases in the group of interstitial lung diseases, which is characterized by persistent progression and poor prognosis. Over the past decade, experts have made significant progress in developing a diagnostic algorithm for IPF patients. This algorithm includes analysis of clinical, laboratory, and instrumental data, primarily the results of high-resolution computed tomography (HRCT). Precise adherence to the diagnostic algorithm and correct interpretation of HRCT data are prerequisites for IPF diagnosis.Specialists of the Tomsk region have developed routing of patients with suspected IPF. The presented clinical case is a successful example of adhering to this algorithm. Wide implementation of modern diagnostic algorithms into diagnosis and treatment of IPF and quality improvement of imaging methods, primarily HRCT, carried out as a part of the differential diagnosis, open up prospects for early diagnosis of this pathology. A timely prescribed antifibrotic therapy (nintedanib, pirfenidone) in IPF allows to slow down pathological progression and improves the prognosis.

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