RESUMEN
Acute chest syndrome is a frequent complication of sickle cell disease. This syndrome is characterized by recent infiltrate on chest X-ray with chest pain or fever or dyspnea. We report the case of a 26-year-old man in whom an acute chest syndrome with fat embolism was the inaugural sign of sickle cell disease. This report illustrates the frequency of potentially serious fat embolism in the acute chest syndrome and the importance of bronchoscopy and bronchoalveolar lavage (fatty macrophages) for determining the etiology of acute chest syndrome.
Asunto(s)
Anemia de Células Falciformes/complicaciones , Anemia de Células Falciformes/diagnóstico , Embolia Grasa/etiología , Enfermedades Pulmonares/etiología , Enfermedad Aguda , Adulto , Lavado Broncoalveolar , Broncoscopía , Disnea/etiología , Humanos , Masculino , SíndromeRESUMEN
Alteration of the air we breathe, due mainly to the transformation of the environment by mankind, is a increasing cause of concern for physicians, public health deciders and government agencies responsible for environmental protection. Modifications of air composition have a proven harmful effect on health and provoke predominantly respiratory symptoms. Asthma is considered as a disease resulting from complex interactions between genetic and environmental factors. Since asthma-related morbidity and mortality have risen constantly over the past decades, many studies were conducted to identify and evaluate the factors responsible for the onset and/or aggravation of the underlying inflammation. Various atmospheric toxic compounds appear to be responsible, and some experts think that asthmatics are excellent indicators for atmospheric pollution and its intensity. Doses and conditions of experimental exposure are however often quite different from real population exposure, implicating very critical evaluation of demonstrated effects and extreme prudence when extrapolating results.
Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Asma/etiología , Exposición a Riesgos Ambientales , Animales , Modelos Animales de Enfermedad , Humanos , InflamaciónRESUMEN
OBJECTIVE: To investigate the significance of circulating adhesion molecules associated with leucocyte-endothelial cell interactions in asthma, serum levels of soluble E (sE)-selectin, soluble P (sP)-selectin, soluble L (sL)-selectin, and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured in mild, moderate and severe asthma. METHOD: Serum levels of sE-selectin, sP-selectin, sL-selectin, and sVCAM-1 were measured in 32 women with asthma and 30 healthy donors using an enzyme-linked immunosorbent assay method. Twenty patients were suffering from severe asthma, and 12 from mild/moderate asthma. RESULTS: Serum sE-selectin and sVCAM-1 levels from patients with asthma were significantly higher than those observed in healthy donors (p < 0.01). The levels of sP-selectin were the same as those of controls. The level of sE-selectin exhibited an important increase in the severe asthmatic patients compared with mild/moderate asthma (p < 0.01). The sVCAM-1 level was increased in severe asthma when compared with healthy controls. There was no correlation between the levels of soluble selectins and the age of the patients. A significant correlation was found between sE-selectin and sVCAM-1 levels. CONCLUSION: These data indicate that circulating soluble forms of the selectins may have different kinetics during the clinical course of asthma, suggesting that they may reflect different inflammatory pathways in severe asthma. Both sVCAM-1 and sE-selectin may be useful immunological markers for monitoring disease activity in asthma.
Asunto(s)
Asma/sangre , Selectina E/sangre , Molécula 1 de Adhesión Celular Vascular/sangre , Adulto , Asma/inmunología , Biomarcadores , Femenino , Humanos , Selectina L/sangre , Persona de Mediana Edad , Selectina-P/sangre , Valor Predictivo de las Pruebas , SolubilidadRESUMEN
We report a case in a patient aged 28 admitted with haemoptysis and dyspnoea. The chest x-ray showed multiple disseminated hydatid cysts throughout the lung fields. Computerized tomography and an abdominal echo found a hydatid cyst of the liver in contact with inferior vena cava which was probably responsible for the secondary pulmonary dissemination. Subsequently there was a multiplication of the lesions with rupture and infection of several cysts. After two years the disease progressed into chronic respiratory failure with the appearance of chronic cor pulmonale. The respiratory state rapidly worsened with several episodes of cardiorespiratory failure. Death occurred six months after the appearance of CPC.
Asunto(s)
Equinococosis Hepática/complicaciones , Equinococosis Pulmonar/complicaciones , Enfermedad Cardiopulmonar/parasitología , Adulto , Enfermedad Crónica , Equinococosis Hepática/diagnóstico por imagen , Equinococosis Pulmonar/diagnóstico por imagen , Resultado Fatal , Humanos , Masculino , Tomografía Computarizada por Rayos XRESUMEN
Pseudotumoral manifestations in the thorax is an unusual presentation of sarcoidosis. We report three such cases including two which mimicked pulmonary metastases with a classic image of multiple lesions in two women aged 31 and 30 years. In the third case, a 51-year-old male smoker had an opacity in the upper left lobe on chest x-ray then developed endobronchial hemorrhage suggestive of a primary bronchogenic cancer. In most cases, bronchial or transbronchial biopsies are sufficient for diagnosis. Surgical biopsy may be required however to eliminate the possibility of tumoral proliferation or an other granulomatous etiology.