scholarly journals Pathology of Granulomatous Pulmonary Diseases

2021 ◽  
Author(s):  
Yale Rosen
Keyword(s):  
Foreign Bodies ◽  
Practical Experience ◽  
Pulmonary Diseases ◽  
Parasitic Infections ◽  
Disease Category ◽  
Drug Induced ◽  
Specific Diagnosis ◽  
Pubmed Search ◽  
Bronchocentric Granulomatosis ◽  
Granulomatous Diseases

Context.— Because granulomas are represented in almost every disease category, the number of clinically and pathologically important granulomatous pulmonary diseases is large. Their diagnosis by pathologists is particularly challenging because of their nonspecificity. A specific diagnosis can be achieved only when a granuloma-inciting agent(s) (eg, acid-fast bacilli, fungi, foreign bodies, etc) are identified microscopically or by culture; this does not occur in most cases. Furthermore, a specific diagnosis cannot be reached in a high percentage of cases. Although sarcoidosis and infectious diseases account for approximately half of pulmonary granulomatous diseases worldwide, there is significant geographic variation in their prevalence. Objectives.— To present updated information to serve as a guide to pathologic diagnosis of pulmonary granulomatous diseases, to address some commonly held misconceptions and to stress the importance of multidisciplinary coordination. Presentation of basic aspects of granulomas is followed by discussion of specific disease entities, such as tuberculous and nontuberculous Mycobacterial infections, fungal, bacterial, and parasitic infections, sarcoidosis, necrotizing sarcoid granulomatosis, berylliosis, hypersensitivity pneumonitis, hot tub lung, rheumatoid nodule, bronchocentric granulomatosis, aspirated, inhaled, and embolized foreign bodies, drug-induced granulomas, chronic granulomatous disease, common variable immunodeficiency, and granulomatous lesions associated with various types of cancer. Data Sources.— Review of pertinent medical literature using the PubMed search engine and the author's practical experience. Conclusions.— Although the diagnosis of granulomatous lung diseases continues to present significant challenges to pathologists, the information presented in this review can be helpful in overcoming them. The importance of multidisciplinary coordination in cases where morphologic diagnosis is not possible cannot be overstated.

Drug-induced pulmonary diseases

2020 ◽  
pp. 393-408
Author(s):  
Alexander Averyanov ◽  
Evgeniya Kogan ◽  
Victor Lesnyak
Keyword(s):  
Pulmonary Diseases ◽  
Drug Induced

scholarly journals Antimicrobial-induced cognitive side effects

2016 ◽  
Vol 6 (4) ◽  
pp. 207-214 ◽  
Author(s):  
Amanda Warstler ◽  
Jennifer Bean
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Side Effects ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Time Frame ◽  
Drug Induced ◽  
Pubmed Search ◽  
Neuropsychiatric Side Effects ◽  
Cognitive Side Effects

Abstract Introduction: Antimicrobial-induced cognitive side effects are often overlooked or underreported. Literature often reports symptoms of antimicrobial-induced cognitive impairment under more general blanket terms, such as neuropsychiatric side effects, neurotoxicity, or drug-induced delirium or encephalopathy. Methods: A PubMed search using terms including antibiotics, antifungals, antivirals, antimalarials, side effects, cognitive, neurotoxicity, encephalopathy, and delirium was conducted. Respectively, symptoms of cognitive impairment were teased out of the multiple neurologic complications presented for each case and reported based on antimicrobial class. Articles were excluded if they focused solely on neuropsychiatric side effects such as seizures, psychosis, hallucinations, or mood disturbances, were conducted in animals, or involved antiretroviral medication therapies. Results: Of over 50 case reviews, case reports, retrospective chart reviews, and prospective cohort studies analyzed, 25 were deemed appropriate for purposes of this review. Common antimicrobial-induced cognitive side effects for all antimicrobial classes included confusion, delirium, encephalopathy, and impaired concentration or attention. Recurring risk factors included, but were not limited to, older age and renal impairment. Mechanisms of cognitive impairment were relatively specific to each antimicrobial class. Discussion: Awareness of the potential for antimicrobial-induced cognitive side effects, including the general time frame of symptom onset and symptom presentation, is critical in challenging patient cases. This review article aims to summarize the risk factors, clinical symptoms, mechanisms, and management of antimicrobial-induced cognitive side effects. Pharmacists can play a key role in prevention through adjustment of medications for renal or hepatic dysfunction, avoidance of polypharmacy, and knowledge of critical drug interactions that may precipitate cognitive decline.

scholarly journals Pneumatosis Intestinalis — A Pitfall for Surgeons?

2005 ◽  
Vol 94 (1) ◽  
pp. 47-50 ◽  
Author(s):  
C. Braumann ◽  
C. Menenakos ◽  
C. A. Jacobi
Keyword(s):  
Gastrointestinal Tract ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Mixed Connective Tissue Disease ◽  
English Literature ◽  
Radiological Finding ◽  
Pneumatosis Intestinalis ◽  
Underlying Disease ◽  
Pulmonary Diseases ◽  
Drug Induced

Pneumatosis intestinalis (PI) is characterized by multiple gas cysts in the wall of the gastrointestinal tract. Primary PI is extremely rare. In most of the cases PI is due to an underlying disease (traumatic and mechanical, inflammatory and autoimmune diseases, infectious and pulmonary diseases, drug induced, immunosuppression, transplantation, or neoplasm). A 69-year-old woman was treated with mixed connective tissue disease and PI twice operatively and once conservatively in our department. Review of the english literature showed 13 more cases of PI with underlying mixed connective tissue disease. Most published cases of pneumatosis intestinalis with radiological finding of pneumoperitoneum were treated conservatively and should have not been considered as a reason for surgery. Therefore, the treatment of PI can present as a major dilemma for the surgeon.

Bronchial Casts in Children

1987 ◽  
Vol 96 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Jay Werkhaven ◽  
Lauren D. Holinger
Keyword(s):  
Cystic Fibrosis ◽  
Physical Therapy ◽  
Clinical Picture ◽  
Foreign Bodies ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Endoscopic Removal ◽  
Underlying Condition ◽  
Bronchocentric Granulomatosis ◽  
Bronchial Casts ◽  
Chest Physical Therapy

Bronchial casts were found in four children during a 2-year period at the Children's Memorial Hospital. These four children represent 0.2% of the 1,943 endoscopic cases during that time. Thirty other cases of bronchial casts have been reported previously in children 9 years of age or younger, only 12 of which were not associated with cystic fibrosis. Casts may be a complication of many diseases; cystic fibrosis, asthma, bronchitis, allergic bronchopulmonary aspergillosis, and bronchocentric granulomatosis are the most common. With the exception of cystic fibrosis, these diseases may all have an allergic pulmonary reaction as the underlying cause. In all four cases reported here, the diagnosis was made at endoscopy because the clinical picture is not dissimilar from that of bronchial foreign bodies. Management includes endoscopic removal of the cast, chest physical therapy with nebulized acetylcysteine, and an evaluation to determine the underlying condition.

Mediastinal FDG-positive lymph nodes simulating melanoma progression: drug-induced sarcoidosis like/lymphadenopathy related to ipilimumab

2021 ◽  
Vol 14 (1) ◽  
pp. e237310
Author(s):  
Carlos González-Cruz ◽  
Domingo Bodet ◽  
Eva Muñoz-Couselo ◽  
Vicente García-Patos
Keyword(s):  
Lymph Nodes ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Tumour Progression ◽  
Emission Tomography ◽  
Drug Induced ◽  
Positron Emission ◽  
Pet Ct ◽  
Granulomatous Diseases

Drug-induced sarcoidosis-like reactions (DISRs) are systemic granulomatous diseases that develop in the context of a new drug onset. Ipilimumab is an immune checkpoint inhibitor (ICI) approved for the treatment of advanced melanoma which has been associated with DISR. Differential diagnosis between tumour progression and DISR by positron emission tomography/computed tomography (PET/CT) in patients treated with an ICI can be a challenge. A 31-year-old woman was diagnosed with a stage IIIB melanoma in her back. Ipilimumab 10 mg/kg was initiated. After 1 month of finishing the treatment a routine, PET/CT showed multiple enlarged mediastinal and hilar lymph nodes FDG-positive. A transbronchial biopsy showed sarcoid-like granulomatous infiltration which favoured the diagnosis of DISR related to ipilimumab. The patient remained asymptomatic and lymphadenopathy regressed progressively after 11 months. Our work highlights the importance of differentiating DISR from tumour progression, before unnecessary changes in therapeutic strategies. PET/CT is a useful diagnostic tool for its follow-up.

scholarly journals Crystalline Nephropathies

2012 ◽  
Vol 136 (7) ◽  
pp. 713-720 ◽  
Author(s):  
Leal C. Herlitz ◽  
Vivette D. D'Agati ◽  
Glen S. Markowitz
Keyword(s):  
Hematologic Malignancy ◽  
High Volume ◽  
Practical Experience ◽  
Renal Tubules ◽  
High Concentration ◽  
Drug Induced ◽  
Accurate Identification ◽  
Pathology Laboratory ◽  
Crystal Deposition ◽  
Concentration Of Ions

Context.—The kidney is a favored site for crystal deposition because of the high concentration of ions and molecules reached at the level of the renal tubules in the course of filtration. This review focuses on crystalline nephropathies in 4 broad categories: (1) dysproteinemia- associated, (2) drug-induced, (3) calcium-containing, and (4) metabolic or genetic. Objective.—To provide a framework for accurate identification of the diverse types of crystals encountered in the kidney in order to formulate an appropriate differential diagnosis and guide additional testing and treatment. Data Sources.—Review of pertinent published literature along with practical experience gained in a high-volume renal pathology laboratory. Conclusions.—Accurate identification of crystals encountered in the kidney is essential in detecting conditions ranging from hematologic malignancy to drug toxicity to metabolic disorders. Detailed clinical-pathologic correlation is needed to accurately diagnose the underlying cause of most crystalline nephropathies.

scholarly journals Burkholderia Septicemia: A Case Report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tarana Sarwat ◽  
Zarine Khan ◽  
Renu Dutta ◽  
Renu Dutta
Keyword(s):  
Cystic Fibrosis ◽  
Heart Disease ◽  
Case Report ◽  
Pleural Effusion ◽  
Burkholderia Cepacia ◽  
Bacterial Pathogen ◽  
Pulmonary Diseases ◽  
Granulomatous Diseases ◽  
Rheumatic Heart ◽  
Multiple Antibiotics

Burkholderia cepacia is a bacterial pathogen which usually causes infection in immunocompromised or hospitalized patients. It also causes associated infections in patients with underlying pulmonary diseases, such as cystic fibrosis and chronic granulomatous diseases. It is often resistant to multiple antibiotics and has been found to grow even in medium containing penicillin. Here, we report a case of B. cepacia bacteremia in a post-operative patient of rheumatic heart disease with bilateral pleural effusion who, on being timely diagnosed, was managed effectively with appropriate antibiotics.

scholarly journals Angioedema, a life-threatening adverse reaction to ACE-inhibitors

2019 ◽  
Vol 9 (36) ◽  
pp. 177-181
Author(s):  
Ramona Ungureanu ◽  
Elena Madalan
Keyword(s):  
Ace Inhibitors ◽  
Neck Region ◽  
Diagnostic Algorithm ◽  
Converting Enzyme ◽  
Drug Induced ◽  
Head And Neck Region ◽  
Specific Diagnosis ◽  
Frequent Form ◽  
The Face ◽  
Life Threatening

Abstract Angioedema with life-threatening site is one of the most impressive and serious reasons for presenting to the ENT doctor. Among different causes (tumors, local infections, allergy reactions), an important cause is the side-effect of the angiotensin converting enzyme (ACE) inhibitors drugs. ACE-inhibitors-induced angioedema is described to be the most frequent form of bradykinin-mediated angioedema presented in emergency and also one of the most encountered drug-induced angioedema. The edema can involve one or more areas of the head and neck region, the most affected being the face, the lips, the tongue, followed by the larynx, when it may determine respiratory distress and even death. There are no specific diagnosis tests available and the positive diagnosis of ACE-inhibitors-induced angioedema is an exclusion diagnosis. The authors performed a review of the most important characteristics of the angioedema caused by ACE-inhibitors and present their experience emphasizing the diagnostic algorithm.

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