Specificity and Sensitivity of Hemosiderin-Laden Macrophages in Routine Bronchoalveolar Lavage in Children

2006 ◽  
Vol 130 (11) ◽  
pp. 1684-1686 ◽  
Author(s):  
Zeynep N. Salih ◽  
Afreen Akhter ◽  
Javeed Akhter
Keyword(s):  
Bronchoalveolar Lavage ◽  
Sensitivity And Specificity ◽  
Pediatric Population ◽  
Strong Association ◽  
Clinical Findings ◽  
Clinical Syndrome ◽  
Pulmonary Hemosiderosis ◽  
Specificity And Sensitivity ◽  
Long Term Prognosis

Abstract Context.—The presence of iron or hemosiderin in macrophages obtained in routine bronchoalveolar lavage is considered crucial in the diagnosis of the clinical syndrome of hemosiderosis. However, there do not appear to be any data on the sensitivity and specificity of the finding of hemosiderin-laden macrophages (HLMs) in bronchoalveolar lavage in children. Objective.—To review data from bronchoalveolar lavage studies done in children to correlate the presence of HLMs with pneumonia and hemosiderosis and to determine what proportion of HLMs has the optimal sensitivity and specificity for the diagnosis of hemosiderosis. Design.—One hundred ten bronchoalveolar lavage specimens obtained via flexible bronchoscopy were reviewed retrospectively. The data collected for demographics, indication for the bronchoscopy, diagnosis of pneumonia, anemia, and bronchoscopy and bronchoalveolar lavage findings were compared between patients diagnosed with hemosiderosis and those diagnosed with other diseases. Results.—Six patients were diagnosed with hemosiderosis by clinical findings, lung biopsy, or autopsy. There were no statistical differences in pneumonia (P > .99), anemia (P > .99), or coughing (P = .08) between patients with hemosiderosis and other patients. Hemoptysis was the only symptom that was significantly different between the 2 groups (P = .04). The mean HLM index for patients with hemosiderosis was 56% ± 16.17% and for other patients, 7.5% ± 10.74% (P < .001). A HLM index of 35% gave a sensitivity of 1% and a specificity of .96%. Conclusions.—These results confirm a strong association between HLM index and diagnosis of hemosiderosis in a pediatric population. Availability of this HLM index will result in accurate and timely diagnosis of pulmonary hemosiderosis, which may influence treatment and long-term prognosis.

Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome – A Pictorial Review

2019 ◽  
Vol 1 ◽  
pp. 41-46
Author(s):  
Moomal Haris ◽  
Harun Gupta
Keyword(s):  
Inflammatory Process ◽  
Clinical Presentation ◽  
Symptom Control ◽  
Clinical Syndrome ◽  
First Line ◽  
Pictorial Review ◽  
Inflammatory Arthropathy ◽  
Inflammatory Drugs ◽  
Long Term Prognosis

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) is an acronym which encompasses SAPHO. SAPHO is a distinct clinical syndrome which involves the musculoskeletal and dermatological systems. The clinical presentation can be variable, and therefore, patients may present to non-specialists who are not familiar with the disease. It is, therefore, important for the radiologist to be aware of the imaging manifestations of SAPHO; as often, it is them who are the first to propose the diagnosis. Imaging allows differentiation of SAPHO from other disease processes such as inflammatory arthropathy, infection, and malignancy which can share similar features and also to demonstrate potentially subclinical areas of disease involvement. Treatment is empirical and aimed at symptom control and modifying the inflammatory process. Nonsteroidal anti-inflammatory drugs are the first-line agents. The disease has a good long-term prognosis, despite the challenges in diagnosis and treatment.

scholarly journals Idiopathic Effusive Constrictive Pericarditis Accompanying Multiple Complications: A Case Report

2020 ◽  
Author(s):  
Chaodi Luo ◽  
Jing Li ◽  
Yang Yan ◽  
Dan Han
Keyword(s):  
Case Report ◽  
Constrictive Pericarditis ◽  
Rare Case ◽  
Clinical Syndrome ◽  
Severe Tricuspid Regurgitation ◽  
Prognostic Predictor ◽  
Parietal Pericardium ◽  
Long Term Prognosis ◽  
Effusive Constrictive Pericarditis

Abstract IntroductionEffusive constrictive pericarditis (ECP) is a unique clinical syndrome that is characterized by the coexistence of pericardial effusion and constrictive pericardium. The etiology of ECP usually contains tuberculosis, idiopathic, and neoplastic causes. The early diagnosis, treatment strategy and prognostic predictor of ECP still remain a big problem nowadays due to the sophisticated clinical situations. Case PresentationWe here report a rare case of idiopathic ECP with thickened adherent visceral pericardium and normal parietal pericardium, accompanying multiple complications mainly comprising severe tricuspid regurgitation, hypoproteinemia, and proximal deep venous thrombosis. The patient was referred for radical pericardiectomy successfully, but the long-term prognosis may be unfavorable. DiscussionThis case aims to provide some clinical experience of such situation in which the clinician should weight the benefits and the risks to a particular patient.

Prognosis and complications

ESC CardioMed ◽  
2018 ◽  
pp. 1715-1720
Author(s):  
Isidre Vilacosta ◽  
Carmen Olmos
Keyword(s):  
Infective Endocarditis ◽  
High Mortality ◽  
Clinical Findings ◽  
Blood Cultures ◽  
Diagnosis And Treatment ◽  
Prognostic Assessment ◽  
Early Risk ◽  
Short And Long Term ◽  
Long Term Prognosis

Nowadays, despite improvements in diagnosis and treatment, infective endocarditis remains associated with high mortality and severe complications. When assessing the prognosis of patients with endocarditis, three different clinical periods are distinguished: prognostic assessment at admission, early risk reassessment during the first week after the beginning of antibiotics, and short- and long-term prognosis after discharge. The three cornerstones for assessing patients’ prognosis can be obtained from clinical findings, echocardiography, and blood cultures. Analytic parameters such as thrombocytopenia may also help to stratify risk.

scholarly journals Comparison between molecular methods (PCR vs LAMP) to detect Candida albicans in bronchoalveolar lavage samples of suspected tuberculosis patients

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Meysam Goodarzi ◽  
Mohammad Hassan Shahhosseiny ◽  
Mansour Bayat ◽  
Seyed Jamal Hashemi ◽  
Mohammad Ghahri
Keyword(s):  
Bronchoalveolar Lavage ◽  
Sensitivity And Specificity ◽  
Isothermal Condition ◽  
High Sensitivity ◽  
High Specificity ◽  
Nucleic Acid Amplification ◽  
Lamp Method ◽  
Specificity And Sensitivity ◽  
Suspected Tuberculosis ◽  
Pcr Test

With the increase of patients suffering from immune deficiency infections also increased pulmonary fungi even in people with defective immune system can cause fatal and lethal candidiasis. The timely diagnosis of pulmonary candidiasis is one of the problems that has been detected. Polymerase chain reaction (PCR) test and Loop mediated isothermal amplification (LAMP) method optimized on the basis of α INT1 gene and then sensitivity and specificity were evaluated. LAMP is a novel nucleic acid amplification technique with high specificity and sensitivity which has been done under isothermal condition. Samples were the bronchoalveolar lavage suspected of tuberculosis (TB) reviews for TB disease negative have been reported. DNA extraction carried out by standard phenol/chloroform method on samples and PCR test and LAMP was done. PCR and LAMP testing was performed on samples and products of 441 bp were amplified and observed with agarose gel electrophoresis. At the end of the LAMP reaction, SYBR Green was used for identifying negative and positive results. Among the 60 quantities sera, only 7 cases were PCR positive but 8 cases were LAMP positive. In comparison, between LAMP and PCR, the LAMP technique in spite of its simplicity, high sensitivity and specificity, could be an appropriate replacement for PCR.

Prognosis and complications

ESC CardioMed ◽  
2018 ◽  
pp. 1715-1720
Author(s):  
Isidre Vilacosta ◽  
Carmen Olmos
Keyword(s):  
Infective Endocarditis ◽  
High Mortality ◽  
Clinical Findings ◽  
Blood Cultures ◽  
Diagnosis And Treatment ◽  
Prognostic Assessment ◽  
Early Risk ◽  
Short And Long Term ◽  
Long Term Prognosis

Nowadays, despite improvements in diagnosis and treatment, infective endocarditis remains associated with high mortality and severe complications. When assessing the prognosis of patients with endocarditis, three different clinical periods are distinguished: prognostic assessment at admission, early risk reassessment during the first week after the beginning of antibiotics, and short- and long-term prognosis after discharge. The three cornerstones for assessing patients’ prognosis can be obtained from clinical findings, echocardiography, and blood cultures. Analytic parameters such as thrombocytopenia may also help to stratify risk.

scholarly journals An Unusual Case of Systemic Lupus Erythematosus and Hemophagocytic Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Saika Sharmeen ◽  
Nazia Hussain
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Hemophagocytic Syndrome ◽  
Pediatric Population ◽  
Clinical Findings ◽  
Clinical Syndrome ◽  
Systemic Lupus ◽  
Immune Mediated ◽  
Prompt Diagnosis

Hemophagocytic syndrome (HS) or hemophagocytic lymphohistiocytosis (HLH) is an immune mediated phenomenon that can occur in the setting of an autoimmune disease, chronic immunosuppression, malignancy, or infection. It has been more commonly described in the pediatric population and less commonly in adults. We describe a case of a 52-year-old male who presented with a rash. He simultaneously met the Systemic Lupus International Collaborating Clinics (SLICC) criteria for the diagnosis of systemic lupus erythematosus (SLE) and the diagnostic criteria of HS as described in the hemophagocytic lymphohistiocytosis (HLH) 2004 trial. The bone marrow on autopsy showed the presence of abundant hemosiderophages with focal hemophagocytosis. SLE-associated HS might be underdiagnosed due to the overlap in clinical findings. This case represents the importance of prompt diagnosis and treatment of such a potentially fatal clinical syndrome.

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