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  1 / 21107 MEDLINE  
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[PMID]:29287885
[Au] Autor:Sheehan CC; Lopez J; Elmaraghy CA
[Ad] Endereço:The Ohio State University College of Medicine, Columbus, OH, United States.
[Ti] Título:Low rate of positive bronchoscopy for suspected foreign body aspiration in infants.
[So] Source:Int J Pediatr Otorhinolaryngol;104:72-75, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To describe our institution's low rate of positive bronchoscopy in infants suspected of inhaling a foreign body. STUDY DESIGN: Retrospective chart review. METHODS: A retrospective review was performed of patients at a tertiary children's hospital with suspected inhalation of a foreign body. Charts were reviewed for demographic information, radiologic findings, operative reports, and respiratory viral panels were reviewed. RESULTS: Sixteen pediatric patients under 12 months of age were identified from 2008 to 2016 with a diagnosis of possible airway foreign body inhalation who underwent emergent bronchoscopy. Of these patients, only one was positive for a foreign body present in the airway. The remaining 15 children were found to have a negative direct laryngoscopy and bronchoscopy evaluation for a foreign body. Of these fifteen patients, 14 were found to have structural airway abnormalities and 7 tested positive for a respiratory viral infection. CONCLUSIONS: Our institution has a low rate of positive bronchoscopy for highly suspected foreign body inhalation in a group of patients less than 12 months of age. Patients presenting with respiratory distress, stridor, or other airway symptoms were often found to have an underlying airway abnormality or viral infection, which coupled with an unclear history, would increase the suspicion for an airway foreign body and subsequent decision to perform bronchoscopy. In stable patients, diagnostic evaluation for an underlying respiratory infection should be performed in these cases. LEVEL OF EVIDENCE: Case Series.
[Mh] Termos MeSH primário: Broncoscopia/estatística & dados numéricos
Corpos Estranhos/diagnóstico
Sistema Respiratório/lesões
[Mh] Termos MeSH secundário: Feminino
Corpos Estranhos/epidemiologia
Hospitais Pediátricos
Seres Humanos
Lactente
Recém-Nascido
Laringoscopia/estatística & dados numéricos
Masculino
Estudos Retrospectivos
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


  2 / 21107 MEDLINE  
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[PMID]:29292978
[Au] Autor:Palm A; Wilander E; Wallgren S; Hillerdal G
[Ad] Endereço:Department of Medical Sciences, Respiratory, Allergy and Sleep Research - Uppsala, Sweden Department of Medical Sciences, Respiratory, Allergy and Sleep Research - Uppsala, Sweden.
[Ti] Título:Sotrökslunga är en ny sjukdom i Sverige - Exponering för rök från biomassa är orsaken..
[So] Source:Lakartidningen;114, 2017 Dec 18.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Ab] Resumo:Black smoke lung disease - a new disease in Sweden We describe two elderly female patients, immigrants to Sweden from Afghanistan, with intensive longtime exposure to smoke from biomass, and who presented with bronchial stenosis and severe bronchial obstruction. CT and X-ray showed bizarre perihilar infiltrates in the lungs. Bronchoscopy revealed black narrow bronchi with a middle lobe stenosis in one of the patients. These findings indicate the diagnosis bronchial anthracofibrosis (BAF). The here described findings are seen mainly in elderly never-smoking women from developing countries who have spent years cooking food in poorly ventilated kitchens. With increased immigration from these countries such cases will be seen in industrialized countries as well. Active tuberculosis must always be excluded but otherwise no more active investigations such as biopsies are warranted. We suggest that this disease should be termed ¼black smoke disease« to differentiate it from coal workers' pneumoconiosis, silicosis, and other classical occupational diseases which can have similar clinical and radiological pictures. This term is easily understood even by non-medical persons and illustratess both the etiology and the black bronchi.
[Mh] Termos MeSH primário: Antracose
Fumaça/efeitos adversos
[Mh] Termos MeSH secundário: Afeganistão/etnologia
Antracose/diagnóstico
Antracose/diagnóstico por imagem
Antracose/etiologia
Antracose/patologia
Biomassa
Broncoscopia
Materiais de Construção/efeitos adversos
Feminino
Seres Humanos
Irã (Geográfico)/etnologia
Meia-Idade
Exposição Ocupacional/efeitos adversos
Radiografia
Suécia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Smoke)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


  3 / 21107 MEDLINE  
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[PMID]:27773666
[Au] Autor:Korevaar DA; Crombag LM; Cohen JF; Spijker R; Bossuyt PM; Annema JT
[Ad] Endereço:Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. Electronic address: d.a.korevaar@amc.uva.nl.
[Ti] Título:Added value of combined endobronchial and oesophageal endosonography for mediastinal nodal staging in lung cancer: a systematic review and meta-analysis.
[So] Source:Lancet Respir Med;4(12):960-968, 2016 12.
[Is] ISSN:2213-2619
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Guidelines recommend endosonography with fine-needle aspiration for mediastinal nodal staging in non-small-cell lung cancer, but most do not specify whether this should be through endobronchial endoscopy (EBUS), oesophageal endoscopy (EUS), or both. We assessed the added value and diagnostic accuracy of the combined use of EBUS and EUS. METHODS: For this systematic review and random effects meta-analysis, we searched MEDLINE, Embase, BIOSIS Previews, and Web of Science, without language restrictions, for studies published between Jan 1, 2000, and Feb 25, 2016. We included studies that assessed the accuracy of the combined use of EBUS and EUS in detecting mediastinal nodal metastases (N2/N3 disease) in patients with lung cancer. For each included study, we extracted data on the age and sex of participants, inclusion criteria regarding tumour stage on imaging, details of the endoscopic testing protocol, duration of each endoscopic procedure, number of lymph nodes sampled, serious adverse events occurring during the endoscopic procedures, the reference standard, and 2 × 2 tables for EBUS, EUS, and the combined approach. We evaluated the added value (absolute increase in sensitivity and in detection rate) of the combined use of EBUS and EUS in detecting mediastinal nodal metastases over either test alone, and the diagnostic accuracy (sensitivity and negative predictive value) of the combined approach. This study is registered with PROSPERO, number CRD42015019249. FINDINGS: We identified 2567 unique manuscripts by database search, of which 13 studies (including 2395 patients) were included in the analysis. Median prevalence of N2/N3 disease was 34% (range 23-71). On average, addition of EUS to EBUS increased sensitivity by 0·12 (95% CI 0·08-0·18) and addition of EBUS to EUS increased sensitivity by 0·22 (0·16-0·29). Mean sensitivity of the combined approach was 0·86 (0·81-0·90), and the mean negative predictive value was 0·92 (0·89-0·93). The mean negative predictive value was significantly higher in studies with a prevalence of 34% or less (0·93 [95% CI 0·91-0·95]) compared with studies with a prevalence of more than 34% (0·89 [0·85-0·91]; p=0·013). We found no significant differences in mean sensitivity and negative predictive value between studies that did EBUS first or EUS first, or between studies that used an EBUS-scope or a regular echoendoscope to do EUS. INTERPRETATION: The combined use of EBUS and EUS significantly improves sensitivity in detecting mediastinal nodal metastases, reducing the need for surgical staging procedures. FUNDING: No external funding.
[Mh] Termos MeSH primário: Broncoscopia/métodos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem
Endossonografia/métodos
Neoplasias Pulmonares/diagnóstico por imagem
Linfonodos/diagnóstico por imagem
Mediastino/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Carcinoma Pulmonar de Células não Pequenas/patologia
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos
Esôfago/diagnóstico por imagem
Feminino
Seres Humanos
Neoplasias Pulmonares/patologia
Linfonodos/patologia
Masculino
Mediastino/patologia
Meia-Idade
Estadiamento de Neoplasias
Valor Preditivo dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  4 / 21107 MEDLINE  
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[PMID]:29465600
[Au] Autor:Ryu C; Boffa D; Bramley K; Pisani M; Puchalski J
[Ad] Endereço:Yale School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine.
[Ti] Título:A novel endobronchial approach to massive hemoptysis complicating silicone Y-stent placement for tracheobronchomalacia: A case report.
[So] Source:Medicine (Baltimore);97(8):e9980, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Airway stabilization for severe, symptomatic tracheobronchomalacia (TBM) may be accomplished by silicone Y-stent placement. Common complications of the Y-stent include mucus plugging and granulation tissue formation. PATIENT CONCERNS: We describe a rare case of massive hemoptysis originating from a silicone Y-stent placed for TBM. DIAGNOSES: An emergent bronchoscopy showed an actively bleeding, pulsatile vessel at the distal end of the left bronchial limb of the Y-stent. It was felt that the bleeding was caused by, or at least impacted by, the distal left bronchial limb of the Y-stent eroding into the airway wall. INTERVENTIONS: We hypothesized that placement of oxidized regenerated cellulose (ORC) would provide initial hemostasis, and the subsequent placement of a biocompatible surgical sealant would lead to definitive resolution. OUTCOMES: ORC provided sufficient hemostasis and the subsequent synthetic polymer reinforced the tissue for complete cessation of the bleed. LESSONS: The combined use of ORC and a biocompatible surgical sealant provided long-term management for life-threatening hemoptysis, and potentially morbid procedures such as embolization or surgery were avoided by advanced endobronchial therapy.
[Mh] Termos MeSH primário: Broncoscopia/métodos
Hemoptise/cirurgia
Hemostase Endoscópica/métodos
Stents/efeitos adversos
Traqueobroncomalácia/cirurgia
[Mh] Termos MeSH secundário: Idoso
Celulose Oxidada/administração & dosagem
Feminino
Hemoptise/etiologia
Hemostáticos/administração & dosagem
Seres Humanos
Implante de Prótese/instrumentação
Implante de Prótese/métodos
Silicones
Traqueobroncomalácia/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cellulose, Oxidized); 0 (Hemostatics); 0 (Silicones)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009980


  5 / 21107 MEDLINE  
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[PMID]:29465555
[Au] Autor:Sheth HS; Maldonado F; Lentz RJ
[Ad] Endereço:D. Y. Patil University School of Medicine, Mumbai, India.
[Ti] Título:Two cases of Dieulafoy lesions of the bronchus with novel comorbid associations and endobronchial ablative management.
[So] Source:Medicine (Baltimore);97(8):e9754, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Dieulafoy lesions are aberrantly large submucosal arteries most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive hemoptysis. PATIENT CONCERNS: We present three episodes of massive hemoptysis in two patients, the first with comorbid Alagille syndrome including multiple cardiac and pulmonary vascular abnormalities and the second with thyroid cancer metastatic to the mediastinum. DIAGNOSES: All episodes were due to Dieulafoy lesions of the bronchus based on bronchoscopic appearance. INTERVENTIONS: Bronchoscopic ablation using Nd:YAP laser was attempted both patients. OUTCOMES: Nd:YAP laser successfully ablated the Dieulafoy lesion in the first case with long-term relief from recurrent hemoptysis. The first episode in the second patient responded to bronchial artery embolization; laser ablation of a different Dieulafoy lesion responsible for the second episode was unsuccessful but additional bronchial artery embolization has provided relief from further episodes. LESSONS: Bronchoscopic ablation of Dieulafoy lesions of the bronchus can provide durable relief from recurrent symptoms. Clinical and anatomical features should be considered carefully before intervention, which should only be attempted by experienced operators with appropriate ancillary support available.
[Mh] Termos MeSH primário: Técnicas de Ablação/métodos
Broncopatias/cirurgia
Broncoscopia/métodos
Hemoptise/cirurgia
Malformações Vasculares/cirurgia
[Mh] Termos MeSH secundário: Idoso
Síndrome de Alagille/patologia
Brônquios/irrigação sanguínea
Brônquios/cirurgia
Broncopatias/complicações
Comorbidade
Feminino
Hemoptise/etiologia
Seres Humanos
Masculino
Neoplasias do Mediastino/secundário
Meia-Idade
Neoplasias da Glândula Tireoide/patologia
Malformações Vasculares/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009754


  6 / 21107 MEDLINE  
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[PMID]:29357388
[Au] Autor:Han Y; Kim HJ; Kong KA; Kim SJ; Lee SH; Ryu YJ; Lee JH; Kim Y; Shim SS; Chang JH
[Ad] Endereço:Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
[Ti] Título:Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis.
[So] Source:PLoS One;13(1):e0191590, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Advances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase in preoperative histological diagnosis. We aimed to evaluate the efficacy and safety of transbronchial lung biopsy using radial endobronchial ultrasound and virtual bronchoscopic navigation (TBLB-rEBUS&VBN) and CT-guided transthoracic needle biopsy (CT-TNB) for tissue diagnosis of small PLs. METHODS: A systematic search was performed in five electronic databases, including MEDLINE, EMBASE, Cochrane Library Central Register of Controlled Trials, Web of Science, and Scopus, for relevant studies in May 2016; the selected articles were assessed using meta-analysis. The articles were limited to those published after 2000 that studied small PLs ≤ 3 cm in diameter. RESULTS: From 7345 records, 9 articles on the bronchoscopic (BR) approach and 15 articles on the percutaneous (PC) approach were selected. The pooled diagnostic yield was 75% (95% confidence interval [CI], 69-80) using the BR approach and 93% (95% CI, 90-96) using the PC approach. For PLs ≤ 2 cm, the PC approach (pooled diagnostic yield: 92%, 95% CI: 88-95) was superior to the BR approach (66%, 95% CI: 55-76). However, for PLs > 2 cm but ≤ 3 cm, the diagnostic yield using the BR approach was improved to 81% (95% CI, 75-85). Complications of pneumothorax and hemorrhage were rare with the BR approach but common with the PC approach. CONCLUSIONS: CT-TNB was superior to TBLB-rEBUS&VBN for the evaluation of small PLs. However, for lesions greater than 2 cm, the BR approach may be considered considering its diagnostic yield of over 80% and the low risk of procedure-related complications.
[Mh] Termos MeSH primário: Pneumopatias/diagnóstico
Neoplasias Pulmonares/diagnóstico
[Mh] Termos MeSH secundário: Biópsia por Agulha/efeitos adversos
Biópsia por Agulha/métodos
Broncoscopia/efeitos adversos
Broncoscopia/métodos
Endossonografia/efeitos adversos
Endossonografia/métodos
Hemoptise/etiologia
Hemorragia/etiologia
Seres Humanos
Biópsia Guiada por Imagem/efeitos adversos
Biópsia Guiada por Imagem/métodos
Pneumopatias/diagnóstico por imagem
Pneumopatias/patologia
Neoplasias Pulmonares/diagnóstico por imagem
Neoplasias Pulmonares/patologia
Pneumotórax/etiologia
Tomografia Computadorizada por Raios X/métodos
Interface Usuário-Computador
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180123
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191590


  7 / 21107 MEDLINE  
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[PMID]:29368477
[Au] Autor:Miller MJ; Soberano; Tallaksen R
[Ti] Título:Endobronchial Hamartoma Causing Postobstructive Pneumonia.
[So] Source:W V Med J;112(5):38-9, 2016 Sep-Oct.
[Is] ISSN:0043-3284
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The current case highlights an uncommon cause of recurrent pneumonia. A 76 year old female presented to her primary care physician multiple times with recurrent left lower lobe pneumonia. After multiple chest radiographs continued to show no improvement despite antibiotics, a CT of the chest was performed and showed an intraluminal lesion in the left lower lobe bronchus. An endoscopic biopsy was performed and showed the lesion to be a hamartoma. The patient subsequently underwent resection of the lesion and her symptoms resolved. This case illustrates the need for further diagnostic testing when recurrent pneumonia presents with the same lobar distribution.
[Mh] Termos MeSH primário: Broncopatias/diagnóstico
Hamartoma/diagnóstico
Pneumonia/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Biópsia
Broncopatias/complicações
Broncopatias/cirurgia
Broncoscopia
Diagnóstico Diferencial
Feminino
Hamartoma/complicações
Seres Humanos
Pneumonia/etiologia
Recidiva
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE


  8 / 21107 MEDLINE  
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[PMID]:29390413
[Au] Autor:Wang L; Lu S; Feng Z; Li L; Niu B; Shuai J; Cao L; Li G; Liu J
[Ad] Endereço:Institute of Pediatric Research.
[Ti] Título:The early examination of combined serum and imaging data under flexible fiberoptic bronchoscopy as a novel predictor for refractory Mycoplasma pneumoniae pneumonia diagnosis.
[So] Source:Medicine (Baltimore);96(50):e9364, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The treatment role of flexible bronchoscopy (FOB) for pediatric refractory Mycoplasma pneumoniae pneumonia (RMPP) has been well documented. Besides, the application indication of FOB is also studied in patients with general MPP (GMPP), especially in those with large pulmonary lesions. This study was designed to examine the diagnostic value of bronchoscopic features for RMPP.The FOB and bronchoalveolar lavage (BAL) were adopted for pediatric patients who showed clinical and radiograph indications. On the basis of the final diagnosis on discharge, patients were divided into general and refractory MPP groups. The clinical, laboratory, and bronchoscopic imaging features were retrospectively investigated between these 2 groups.From June 2012 to May 2014, a total of 62 RMPP and 101 GMPP patients were treated with therapeutic bronchoscopy. The comparison analysis showed that the CRP, HBDH, LDH were significantly different between RMPP and GMPP groups (all P < .001). In the bronchoscopic imaging, the mucus plug was significantly more commonly seen in the RMPP group (P < .001). Receiver operating characteristic (ROC) analysis revealed that the combined serum, clinical, and FOB imaging data possessed greater specificity and sensitivity than serum and clinical data alone.Our data suggest that the combined serum, clinical, and bronchoscopic imaging data might serve as a promising predictor for early RMPP diagnosis for pediatric patients with large pulmonary lesions.
[Mh] Termos MeSH primário: Diagnóstico Precoce
Pneumonia por Mycoplasma/diagnóstico
[Mh] Termos MeSH secundário: Testes de Aglutinação
Biomarcadores/sangue
Lavagem Broncoalveolar
Broncoscopia
Pré-Escolar
Diagnóstico Diferencial
Feminino
Seres Humanos
Lactente
Masculino
Pneumonia por Mycoplasma/microbiologia
Valor Preditivo dos Testes
Reação em Cadeia da Polimerase em Tempo Real
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009364


  9 / 21107 MEDLINE  
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[PMID]:29390345
[Au] Autor:Liu A; Zhang Q; Liu B; Xu N; Li A
[Ti] Título:A case of immunoglobulin G4-related lung disease with bilateral diffuse infiltration: A case report.
[So] Source:Medicine (Baltimore);96(50):e9211, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a rare and chronic progressive autoimmune disease. It is a novel clinical entity characterized by elevated serum IgG4 concentration and tissue infiltration by IgG4 plasma cells. IgG4-related lung disease (IgG4-RLD) has been described as interstitial pneumonia and inflammatory pseudotumor, with various abnormal radiographic patterns. We report a case of IgG4-related lung disease with bilateral diffuse infiltration. PATIENT CONCERNS: A 65-year-old woman was admitted to our hospital because of cough, sputum, and fever. Chest computed tomography (CT) revealed multifocal areas of consolidations, nodules, and ground glass opacities in both lungs. She still had fever after anti-infective therapy. DIAGNOSES: Bronchial bronchoscopy and percutaneous lung biopsy were performed, resulted in a pathological diagnosis of IgG4-RLD. INTERVENTIONS: The patient was started on oral prednisolone 30 mg/day for 28 days, and then was gradually tapered. OUTCOMES: After one week treatment, the temperature was stable, CT showed significant improvement in the areas of consolidations and nodules. LESSONS: It is a typical case of IgG4-RLD. This case indicated that suggestive evidence, radiological appearances, serum tests, pathological characteristics, and classic therapy IgG4-RLD. It is a rare disease that needs our more attention in future.
[Mh] Termos MeSH primário: Doenças Autoimunes/diagnóstico
Imunoglobulina G/imunologia
Pneumopatias/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Doenças Autoimunes/tratamento farmacológico
Biópsia
Broncoscopia
Diagnóstico Diferencial
Feminino
Glucocorticoides/uso terapêutico
Seres Humanos
Pneumopatias/tratamento farmacológico
Prednisolona/uso terapêutico
Doenças Raras
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 0 (Immunoglobulin G); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009211


  10 / 21107 MEDLINE  
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[PMID]:27770251
[Au] Autor:Tertemiz KC; Alpaydin AO; Karacam V
[Ad] Endereço:Department of Pulmonary Diseases, Dokuz Eylul University Medical Faculty, 35340, Balcova, Izmir, Turkey. tkemalcan@yahoo.com.
[Ti] Título:The role of endobronchial ultrasonography for mediastinal lymphadenopathy in cases with extrathoracic malignancy.
[So] Source:Surg Endosc;31(7):2829-2836, 2017 Jul.
[Is] ISSN:1432-2218
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Many extrathoracic malignancies can metastasize to lungs and mediastinal lymph nodes. Whether mediastinal lesions are metastasis in these patients changes staging, prognosis, and treatment strategy. In this study, we aimed to find out the contribution of EBUS-TBNA to the diagnosis in cases with extrathoracic malignancy. MATERIALS AND METHODS: Patients who had been previously diagnosed as extrapulmonary solid organ malignancy and in whom mediastinal or hilar lymphadenopathy developed during their follow-up and EBUS-TBNA was applied for diagnostic purposes were retrospectively included in this study. RESULTS: A total of 91 patients consisting of 35 females (38.5 %) and 56 males (61.5 %) were included in the study. The mean age of the patients was 60.5 (±11.4). Malignancy was not observed in 54 (59.3 %) patients; primary malignancy metastasis was detected in 33 (36.3 %) patients, and primary lung cancer was detected in 4 (4.4 %) patients with EBUS-TBNA. The sensitivity of EBUS-TBNA in extrathoracic malignancies was determined as 90.2 %; its specificity was determined as 100 %, its negative predictive value as 92.5 %, its positive predictive value as 100 %, and its diagnostic accuracy as 95.6 %. The highest rate was determined in the left lower paratracheal lymph node when they were examined in terms of malignancy detection rate in lymph node stations. CONCLUSION: EBUS-TBNA is a minimally invasive method with quite a low complication rate that does not require general anesthesia. It should be the first step method to be used in the diagnosis of mediastinal and hilar lymphadenopathies seen in extrathoracic malignancies since it has high diagnostic accuracy, sensitivity, and specificity. EBUS-TBNA significantly reduces the need for surgical intervention. Further surgical interventions can be planned in patients in whom diagnostic competence is not ensured.
[Mh] Termos MeSH primário: Broncoscopia/métodos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos
Neoplasias Pulmonares/diagnóstico por imagem
Neoplasias Pulmonares/secundário
Linfonodos/diagnóstico por imagem
Linfadenopatia/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Feminino
Seguimentos
Seres Humanos
Neoplasias Pulmonares/patologia
Linfonodos/patologia
Linfadenopatia/patologia
Metástase Linfática
Masculino
Mediastino
Meia-Idade
Estudos Retrospectivos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1007/s00464-016-5293-z



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