Chronic Obstructive Lung Disease in young: Alpha 1 anti trypsin deficiency

Alpha-1 antitrypsin (AAT) deficiency is a clinically under recognized inherited disorder. The main clinical manifestations relate to three separate organs: the lung, the liver, and the skin. In the lung, severe deficiency of AAT predisposes to chronic obstructive pulmonary disease. We present a case of 34 years male with a history of recurrent chest infections in past and treated in the line of bronchial asthma but not relieved. He was admitted on 22nd May 2011 at BPKIHS. He presented with type 2 respiratory failure and had features of severe pulmonary arterial hypertension and left lower lobe pneumonia. The patient got improved with the treatment and is doing well on follow up. The diagnosis should be strongly suspected in patients with history suggestive of bronchial asthma and with obstructive features.Journal of Advances in Internal Medicine 2014;3(2):65-67

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Imaging in alpha-1 antitrypsin deficiency: a window into the disease

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211024523 ◽

2021 ◽

Vol 12_suppl ◽

pp. 204062232110245

Author(s):

Yuh-Chin Tony Huang ◽

Marion Wencker ◽

Bastiaan Driehuys

Keyword(s):

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Essential Information ◽

Plain Chest Radiograph ◽

Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin Deficiency ◽

History Of ◽

Detailed Assessment ◽

Alpha 1 Antitrypsin ◽

Magnetic Resonance Imaging Mri

Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (129Xe) lung magnetic resonance imaging (MRI) is emerging as a promising complement to CT by adding comprehensive measures of regional lung function. It also avoids the main disadvantage of CT: the associated radiation. This chapter provides an overview of technological aspects of imaging in AATD, as well as its role in the management of patients and clinical research. In addition, perspectives on the future potential role of lung MRI in AATD are outlined.

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High prevalence of undiagnosed COPD among patients evaluated for suspected myocardial ischaemia

Open Heart ◽

10.1136/openhrt-2018-000848 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000848 ◽

Cited By ~ 1

Author(s):

Andreas Jönsson ◽

Artur Fedorowski ◽

Gunnar Engström ◽

Per Wollmer ◽

Viktor Hamrefors

Keyword(s):

Myocardial Ischaemia ◽

Chronic Obstructive Lung Disease ◽

Chronic Obstructive ◽

Clinical Factors ◽

Obstructive Pulmonary Disease ◽

Presenting Symptoms ◽

High Prevalence ◽

History Of ◽

Artery Disease ◽

Global Initiative

ObjectiveChronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of global morbidity and mortality. Despite the well-known comorbidity between COPD and CAD, the presence of COPD may be overlooked in patients undergoing coronary evaluation. We aimed to assess the prevalence of undiagnosed COPD among outpatients evaluated due to suspected myocardial ischemia.MethodsAmong 500 outpatients who were referred to myocardial perfusion imaging due to suspected stable myocardial ischaemia, 433 patients performed spirometry. Of these, a total of 400 subjects (age 66 years; 45% women) had no previous COPD diagnosis and were included in the current study. We compared the prevalence of previously undiagnosed COPD according to spirometry criteria from The Global Initiative for Chronic Obstructive Lung Disease (GOLD) or lower limit of normal (LLN) and reversible myocardial ischaemia according to symptoms and clinical factors.ResultsA total of 134 (GOLD criteria; 33.5 %) or 46 patients (LLN criteria; 11.5%) had previously undiagnosed COPD, whereas 55 patients (13.8 %) had reversible myocardial ischaemia. The presenting symptoms (chest discomfort, dyspnoea) did not differ between COPD, myocardial ischaemia and normal findings. Except for smoking, no clinical factors were consistently associated with previously undiagnosed COPD.ConclusionsAmong middle-aged outpatients evaluated due to suspected myocardial ischaemia, previously undiagnosed COPD is at least as common as reversible myocardial ischaemia and the presenting symptoms do not differentiate between these entities. Patients going through a coronary ischaemia evaluation should be additionally tested for COPD, especially if there is a positive history of smoking.

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CLINICAL PROFILE OF ASTHMA IN MALE SMOKERS

10.36106/ijsr/4701462 ◽

2021 ◽

pp. 41-42

Author(s):

Pankaj Singh ◽

Ashish Tyagi ◽

Nalin Joshi

Keyword(s):

Bronchial Asthma ◽

Clinical Symptoms ◽

Past History ◽

Positive Family History ◽

Forced Expiratory Volume ◽

Chronic Obstructive ◽

Functional Abnormality ◽

Obstructive Pulmonary Disease ◽

Reversible Airway Obstruction ◽

History Of

Introduction: st Asthma is traditionally dened as a functional abnormality with reversibility in forced expiratory volume in 1 second of more than 15% as opposed to irreversible or xed airway limitation in chronic obstructive pulmonary disease (COPD).This study aims to the assess the clinical symptoms, physical ndings and laboratory results in smoker patients reporting with symptoms suggestive of bronchial asthma . Material and method: This study was conducted in department of Respiratory Medicine of National institute of Medical sciences and research, Jaipur on 50 outdoor male smokers presented with respiratory complaints during period of September 2020 to May 2021. Result: 100 patients enrolled in this study. And 50 patients were diagnosed as bronchial asthma on the basis of steroid trial. Mean age of patients in our study is 48.00+10.41. Shortness of breath (48%) was the commonest complaint followed by cough(24%), expectoration (20%) and last was chest pain (8%). There were more current smokers (48%) followed by ex smokers (32%0 and least were reformed (20%).The most common symptoms in past history of patient was seasonal variation (96%) followed by eye itching (32%), chest tightness (60%), sneezing (56%), dust allergy(32%), non respiratory allergy and wheeze (24%) and last was positive family history of asthma or allergy. Past history showed different variation in which any one symptoms was present in 100% of patients, followed by 2 symptoms (95%), 3 symptoms (84%) and 4 symptoms (52%). Conclusion: This study concludes that presence of any two of the above described past symptoms or variables suggestive of asthma in past are diagnostic of asthma in smoker patients even in the presence of irreversible or partially reversible airway obstruction

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Risk factors of bronchial asthma, chronic obstructive lung disease and «OVERLAP» syndrome asthma-COPD among adults in Ekaterinburg

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja133 ◽

2018 ◽

Vol 15 (4) ◽

pp. 26-29

Author(s):

V C Abdullaev ◽

E K Beltyukov ◽

V V Naumova

Keyword(s):

Risk Factors ◽

Bronchial Asthma ◽

Chronic Obstructive Lung Disease ◽

Overlap Syndrome ◽

Chronic Obstructive ◽

Actual Risk ◽

History Of ◽

Definition Of ◽

The Impact ◽

Over 40 Years

Topicality. Prevalence of bronchial asthma (BA) and COPD achieves in different countries 18 and 20% respectively. The prevalence of «OVERLAP» syndrome - ASTHMA/COPD in Russia is unknown. Objective. To determine the prevalence ofBA, COPD and «OVERLAP» syndrome - ASTHMA/COPD. Materials and methods. The study included a survey using a specially developed questionnaire to identify asthma-like symptoms (ALS), risk factors for BA, COPD, and the definition of FEV^ FEV^FVC in adults in Ekaterinburg. Results. The study has revealed that the risk factors for developing ALS are exposure to tobacco smoke and age over 40 years. The impact of allergens and family history of allergy are less significant. Decrease of spirometry indices is associated with smoking, age over 40 years and the presence of ALS. The diagnostic criteria for the «OVERLAP» syndrome - ASTHMA/COPD were developed based on the answers to the questionnaire on ALS, risk factors and the results of the screening spirometry. Conclusions. Preliminary prevalence ofBA, COPD, «OVERLAP» syndrome - ASTHMA/COPD and actual risk factors have been established in Ekaterinburg in 2018. Unfavorable situation with prevalence of smoking in Ekaterinburg has been showing.

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Chronic obstructive lung disease and COVID-19: topical issues

Russian Pulmonology ◽

10.18093/0869-0189-2020-30-5-599-608 ◽

2020 ◽

Vol 30 (5) ◽

pp. 599-608 ◽

Cited By ~ 1

Author(s):

A. M. Shchikota ◽

I. V. Pogonchenkova ◽

E. A. Turova ◽

M. A. Rassulova ◽

S. A. Gumenyuk

Keyword(s):

Severe Disease ◽

Clinical Manifestations ◽

Chronic Obstructive Lung Disease ◽

New Drugs ◽

Chronic Obstructive ◽

Disease Course ◽

Obstructive Pulmonary Disease ◽

Negative Results ◽

Diagnostic Difficulties ◽

Treatment And Diagnosis

The problem of comorbidity of new coronaviral infection (COVID-19) and chronic obstructive pulmonary disease (COPD) is acute, considering similarity of clinical manifestations, diagnostic difficulties, the potential severe disease course. Patients with COPD represent a vulnerable group of infected SARS-CoV-2, with a complicated disease course and frequent adverse outcome. Features of the spread of the virus limit treatment and diagnosis for patients with COPD, making it difficult to provide medical care during the pandemic. The negative results of some clinical studies of antiviral drugs for patients with COVID-19 indicate the need for a search for new drugs; for this reason, analysis of the anti-inflammatory effect on the lungs in infection COVID-19 of drugs of basic COPD therapy is promising.

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Pellagra in the USA: unusual manifestations of a rare entity

BMJ Case Reports ◽

10.1136/bcr-2019-230972 ◽

2019 ◽

Vol 12 (9) ◽

pp. e230972 ◽

Cited By ~ 1

Author(s):

Ana Rivadeneira ◽

Patricia Moyer ◽

Justin D Salciccioli

Keyword(s):

Adrenal Insufficiency ◽

Clinical Syndrome ◽

Vitamin Supplementation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Medical Evaluation ◽

Severe Deficiency ◽

The Usa ◽

History Of ◽

Function Testing

The case involves a 62-year-old female native of the USA with a history of bipolar disorder and chronic obstructive pulmonary disease who presented with intractable diarrhoea. Prior to the index admission, she was admitted to the intensive care unit and required pericardiocentesis for an idiopathic pericardial effusion with tamponade physiology. Following discharge, she suffered intractable diarrhoea and represented for medical evaluation. She had a painful, swollen tongue as well as persistent hypoglycaemia and required glucose infusions. She had adrenal function testing which revealed adrenal insufficiency. Vitamin testing revealed normal B12 and folate levels but undetectable levels of thiamine, riboflavin and niacin. Her symptoms and signs resolved entirely with appropriate vitamin supplementation. Niacin (vitamin B3) is essential for multiple metabolic pathways, and severe deficiency may cause clinical syndrome of pellagra which is most commonly associated with diarrhoea, delirium and dermatitis. Additional physiological derangements may include adrenal insufficiency, insulin hypersensitivity and pericarditis.

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Respiratory tuberculosis associated with chronic obstructive lung disease - actual problem of modern phthisiology

Vestnik of Russian military medical Academy ◽

10.17816/brmma25990 ◽

2020 ◽

Vol 22 (1) ◽

pp. 185-190

Author(s):

A V Katicheva ◽

N A Brazhenko ◽

O N Brazhenko ◽

S G Zheleznyak ◽

N V Tsygan

Keyword(s):

Pulmonary Tuberculosis ◽

Respiratory System ◽

Clinical Manifestations ◽

Chronic Obstructive Lung Disease ◽

Premature Death ◽

Cardiovascular Complications ◽

Chronic Obstructive ◽

Actual Problem ◽

Obstructive Pulmonary Disease ◽

Number Of Patients

In modern conditions, the problems of tuberculosis of the respiratory system and chronic obstructive pulmonary disease are highly relevant. Tuberculosis remains high among the population. During its course, the frequency of common destructive forms, the number of patients with multiple and extensive drug resistance of mycobacteria, and comorbid conditions in which pulmonary tuberculosis is combined with immunodeficiency and respiratory pathology increased. Chronic tobacco intoxication and chronic obstruction in the lungs increase the activity of tuberculosis inflammation, contribute to the development of common forms of pulmonary tuberculosis, accompanied by abundant bacterial excretion and destruction of lung tissue. In patients with comorbid pathology, pronounced clinical manifestations of the disease, deep functional disorders in the respiratory system and homeostatic balance of the organism are determined. Chronic tobacco intoxication and chronic obstruction in the bronchi have a significant impact on the processes of atherogenesis, systemic inflammation, endothelial dysfunction and the formation of cardiovascular pathology. These phenomena contribute to insufficient treatment efficiency, the formation of pronounced residual changes in the respiratory organs, a decrease in the quality and life expectancy of patients, a high frequency of exacerbation (relapse) and pose a threat to the spread of tuberculosis. In patients with comorbid pathology, cardiovascular complications, dyslipidemia and atherogenesis appear much more often, which are predictors of early disability and premature death.

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A CORRELATIVE STUDY OF ELECTROCARDIOGRAPHY, ECHOCRDIOGRAPHY AND HEMATOLOGICAL FINDINGS IN CHRONIC OBSTRUCTIVE LUNG DISEASE

10.36106/ijar/2412836 ◽

2021 ◽

pp. 3-3

Author(s):

B.Pani Kumar ◽

Arshida Arshida ◽

Sravan kumar

Keyword(s):

Cause Of Death ◽

Obstructive Lung Disease ◽

Respiratory Symptoms ◽

Chronic Obstructive Lung Disease ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Mortality And Morbidity ◽

The Third ◽

History Of

INTRODUCTION Chronic obstructive pulmonary disease is one of the commonest cause of mortality and morbidity in our country. It is dened as “a common preventable and treatable disease characterised by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.” COPD is currently fourth leading cause of death in the world1 but is projected to be the third leading cause of death by 2020. Advances in understanding the pathogenesis of COPD have the potential for identifying new therapeutic targets that could alter the natural history of this devastating disorder.

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Serum laminin levels in eosinophilic and non-eosinophilic chronic obstructive pulmonary disease patients

10.22514/sv.2021.018 ◽

2021 ◽

Keyword(s):

Disease Severity ◽

Chronic Obstructive Lung Disease ◽

Control Group ◽

Chronic Obstructive ◽

Blood Eosinophil ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

History Of ◽

Global Initiative ◽

Complete Blood Counts

Aim: To compare serum laminin levels in eosinophilic and non-eosinophilic (neutrophilic) COPD patients and to define its association with disease severity. Material and Method: This prospective study included patients with mild, moderate, severe, and very severe stable COPD and a control group of patients with a history of smoking but with no signs or symptoms of COPD. Spirometric measurements and Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, was used to define the disease severity. Blood eosinophil percentage was recorded from complete blood counts. Serum laminin levels were measured in all patients. Results: A total of 216 patients were included in the study. Ninety were in the eosinophilic COPD, 90 were in the non-eosinophilic COPD and 36 were in the control groups. In both COPD groups, serum laminin levels were significantly higher than in the control group (P = 0.001). In the eosinophilic COPD group, serum laminin levels were significantly higher than the non-eosinophilic COPD group (P = 0.001). With an increase in COPD severity, laminin levels were higher in both COPD groups (P = 0.001). In correlation analysis performed in all COPD patients, laminin levels were positively correlated with eosinophilia percentage (r = 0.316, P = 0.001) and negatively correlated with the FEV1/FVC ratio (r = -0.160, P = 0. 032). Conclusion: Laminin has an important role in eosinophilic COPD and increased serum laminin levels are associated with an increase in serum eosinophilia percentage and a decrease in respiratory capacity.

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Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary

European Respiratory Journal ◽

10.1183/13993003.00214-2017 ◽

2017 ◽

Vol 49 (3) ◽

pp. 1700214 ◽

Cited By ~ 304

Author(s):

Claus F. Vogelmeier ◽

Gerard J. Criner ◽

Fernando J. Martinez ◽

Antonio Anzueto ◽

Peter J. Barnes ◽

...

Keyword(s):

Chronic Obstructive Lung Disease ◽

Global Strategy ◽

Chronic Obstructive ◽

Comorbid Conditions ◽

Pharmacological Treatments ◽

Executive Summary ◽

Obstructive Pulmonary Disease ◽

Treatment Assessment ◽

Symptom Evaluation ◽

History Of

This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. The most significant changes include: 1) the assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; 2) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; 3) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; 4) nonpharmacologic therapies are comprehensively presented and; 5) the importance of comorbid conditions in managing COPD is reviewed.

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