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Hypersensitivity pneumonia

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https://www.readbyqxmd.com/read/28648751/the-muc5b-promoter-polymorphism-and-telomere-length-in-patients-with-chronic-hypersensitivity-pneumonitis-an-observational-cohort-control-study
#1
Brett Ley, Chad A Newton, Isabel Arnould, Brett M Elicker, Travis S Henry, Eric Vittinghoff, Jeffrey A Golden, Kirk D Jones, Kiran Batra, Jose Torrealba, Christine Kim Garcia, Paul J Wolters
BACKGROUND: Patients with hypersensitivity pneumonitis are at risk of developing pulmonary fibrosis, which is associated with reduced survival. In families with multiple affected members, individuals might be diagnosed as having idiopathic pulmonary fibrosis (IPF) or chronic (fibrotic) hypersensitivity pneumonitis, which suggests these disorders share risk factors. We aimed to test whether the genomic risk factors associated with the development and progression of IPF are also associated with the development of fibrosis and reduced survival in people with chronic hypersensitivity pneumonitis...
June 22, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28617305/fibrotic-hypersensitivity-pneumonitis-key-issues-in-diagnosis-and-management
#2
REVIEW
Vasileios Kouranos, Joseph Jacob, Andrew Nicholson, Elizabetta Renzoni
The diagnosis of hypersensitivity pneumonitis (HP) relies on the clinical evaluation of a number of features, including a history of significant exposure to potentially causative antigens, physical examination, chest CT scan appearances, bronchoalveolar lavage lymphocytosis, and, in selected cases, histology. The presence of fibrosis is associated with higher morbidity and mortality. Differentiating fibrotic HP from the idiopathic interstitial pneumonias can be a challenge. Furthermore, even in the context of a clear diagnosis of fibrotic HP, the disease behaviour can parallel that of idiopathic pulmonary fibrosis in a subgroup, with inexorable progression despite treatment...
June 15, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28614213/pathologic-separation-of-chronic-hypersensitivity-pneumonitis-from-fibrotic-connective-tissue-disease-associated-interstitial-lung-disease
#3
Andrew Churg, Joanne L Wright, Christopher J Ryerson
Chronic (fibrotic) hypersensitivity pneumonitis (HP) and fibrosing interstitial pneumonias associated with connective tissue disease (CTD-ILD) can be difficult to distinguish in biopsy specimens. To investigate features that might separate these entities, 2 pathologists blinded to the diagnoses reviewed 16 cases of chronic HP and 12 cases of CTD-ILD. Fifteen predefined parameters were examined by morphometric point counting, analysis/cm of lung tissue, or presence/absence. Germinal centers were present in a minority of patients, but favored a diagnosis of CTD-ILD (7/12 CTD vs...
June 13, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28610674/elevated-serum-d-dimer-level-is-associated-with-an-increased-risk-of-acute-exacerbation-in-interstitial-lung-disease
#4
Genta Ishikawa, Samuel O Acquah, Mary Salvatore, Maria L Padilla
BACKGROUND: Early recognition of patients with interstitial lung disease (ILD) who have an increased risk of developing acute exacerbation (AE) or preclinical AE may be clinically useful, since AE is associated with poor outcome and preventive measures would be of interest to ILD researchers. This study evaluated the relationship between elevated serum D-dimer level (≥0.4 mcg/mL) and subsequent AE or preclinical AE in patients with ILD. METHODS: This single-center, retrospective study was performed from October 2009 through September 2015 in patients with ILD who were ≥18 years old and had idiopathic pulmonary fibrosis, other idiopathic interstitial pneumonias, chronic hypersensitivity pneumonitis, ILD related to collagen tissue disease, or combined pulmonary fibrosis/emphysema...
July 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28598197/hypersensitivity-pneumonitis-perspectives-in-diagnosis-and-management
#5
Martina Vasakova, Ferran Morell, Simon Walsh, Kevin Leslie, Ganesh Raghu
Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease caused by recurrent exposure to one or more offending inducers in genetically susceptible individuals. It mimics other acute and chronic pulmonary diseases and is often misdiagnosed as idiopathic pulmonary fibrosis (IPF) or another idiopathic interstitial pneumonia if the history of exposure to the inducer is not elicited. We propose a new classification of HP based not only on clinical data but also radiologic and histopathologic findings which might have potential to serve as predictors of disease behaviour and therefore guide management...
June 9, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28537805/pathology-of-chronic-hypersensitivity-pneumonitis-what-is-it-what-are-the-diagnostic-criteria-why-do-we-care
#6
Andrew Churg, AnaMaria Bilawich, Joanne L Wright
CONTEXT: - Chronic hypersensitivity pneumonitis (CHP) has emerged from obscurity during the past 15 years and is now recognized as a very common form of fibrosing interstitial pneumonia but one that is frequently misdiagnosed both clinically and on surgical lung biopsy as usual interstitial pneumonia/idiopathic pulmonary fibrosis (UIP/IPF) or fibrotic nonspecific interstitial pneumonia. OBJECTIVE: - To review the pathologic features of CHP. DATA SOURCES: - Clinical, pathology, and radiology literature were used...
May 24, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28523329/respiratory-bronchiolitis-associated-interstitial-lung-disease-an-unexpected-form-of-idiopathic-interstitial-pneumonia-in-a-young-male
#7
Claudia Lucia Toma, Elena Danteş, Diana Gabriela Leonte, Ariadna Petronela Fildan
Cigarette smoking is the most frequently encountered risk factor for chronic obstructive pulmonary disease and lung cancer. The latest American Thoracic Society÷European Respiratory Society classification of idiopathic interstitial pneumonia includes two entities related to smoking habits: respiratory bronchiolitis-associated interstitial lung disease and desquamative interstitial pneumonia. The new approach to diagnosis is to combine pathological pattern with clinical and radiological data. Lung biopsy is no longer considered the "gold standard" for diagnosis, but as a part of the diagnosis, which shall be set only after the pulmonologist, radiologist and pathologist reviewed all clinical, imaging and pathological aspects...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28515564/delayed-stevens-johnson-syndrome-secondary-to-the-use-of-lamotrigine-in-bipolar-mood-disorder
#8
Kunal Kishor Jha, Durgesh Prasad Chaudhary, Tshristi Rijal, Semanta Dahal
Lamotrigine is a mood-stabilizing drug used in maintenance treatment of bipolar I disease. There are adverse effects with lamotrigine such as a headache, blurred vision, diplopia, somnolence, ataxia, dizziness, rash, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis. SJS is a life-threatening, blistering mucocutaneous disease. SJS is characterized by the presence of flat, diffuse erythematous maculopapular rashes with the involvement of <10% of the body surface area. Standard trigger is drugs including anticonvulsants, antibiotics, and Mycoplasma pneumoniae infection...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28513923/histological-variability-and-consequences-in-chronic-bird-related-hypersensitivity-pneumonitis
#9
Junichi Ochi, Yoshio Ohtani, Tamiko Takemura, Takumi Akashi, Tomoya Tateishi, Yasunari Miyazaki, Naohiko Inase, Yasuyuki Yoshizawa
BACKGROUND AND OBJECTIVE: Lobar and temporal histological variability in chronic bird-related hypersensitivity pneumonitis (BRHP) has not been clearly elucidated. This study was designed to evaluate the spatio-temporal histopathological variability in chronic BRHP. METHODS: Fifty-two patients with chronic BRHP who underwent a surgical lung biopsy (SLB) between 1992 and 2008 were evaluated. The histopathological characteristics of the lung biopsy specimens were classified by the 2002 American Thoracic Society/European Respiratory Society (ATS/ERS) consensus classification of idiopathic interstitial pneumonias (IIPs)...
May 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28503304/clinico-pathologic-presentation-of-hypersensitivity-pneumonitis-in-egyptian-patients-a-multidisciplinary-study
#10
Dalia Abd El-Kareem, Yosri M Akl, Gina A Nakhla, Ali A Elhindawi, Mahmoud A Eltorky
BACKGROUND: Hypersensitivity pneumonitis (HP) is a common diffuse parenchymal lung disease in Egypt which can be difficult to recognize due to the dynamic symptoms & associated environmental factors. METHODS: Forty-three Egyptian patients were enrolled in this study, presenting with dyspnea and cough, predominant ground-glass opacity (GGO) in high-resolution computed tomography (HRCT) where lung biopsy was needed to establish the diagnosis. RESULTS: The age range was 15 to 60 years...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28469989/drug-induced-hypersensitivity-reaction-a-case-of-simultaneous-thyroiditis-and-fulminant-type-1-diabetes
#11
Michael Marchese, Matthew Leinung, Hassan Shawa
A 43-year-old incarcerated man with AIDS was hospitalized for 30 pounds weight loss and diffuse pruritic rash. Three months prior, he was started on dapsone for Pneumocystis jiroveci pneumonia prevention. Biochemical evaluation was remarkable for eosinophilia, thrombocytopenia, acute renal insufficiency, transaminitis, thyrotoxicosis, and significant hyperglycemia (450 mg/dl; nl, 65-99). His hemoglobin A1c level was 5.9% (nl, 4.1-5.6). Thyroid-stimulating immunoglobulin, glutamic acid decarboxylase, and islet cell autoantibodies were within the normal range...
April 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28404157/nab-paclitaxel-versus-solvent-based-paclitaxel-in-patients-with-previously-treated-advanced-gastric-cancer-absolute-an-open-label-randomised-non-inferiority-phase-3-trial
#12
Kohei Shitara, Atsuo Takashima, Kazumasa Fujitani, Keisuke Koeda, Hiroki Hara, Norisuke Nakayama, Shuichi Hironaka, Kazuhiro Nishikawa, Yoichi Makari, Kenji Amagai, Shinya Ueda, Kazuhiro Yoshida, Hideki Shimodaira, Tomohiro Nishina, Masahiro Tsuda, Yukinori Kurokawa, Takao Tamura, Yasutsuna Sasaki, Satoshi Morita, Wasaburo Koizumi
BACKGROUND: Weekly administration of solvent-based paclitaxel is one of the standard second-line chemotherapy regimens for advanced gastric cancer. Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) was developed to improve the solubility of paclitaxel and does not need premedication to avoid infusion-related reactions associated with solvent-based paclitaxel. Additionally, higher doses of nab-paclitaxel can be administered over a shorter infusion time and at higher drug concentrations compared with solvent-based paclitaxel...
April 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28350485/ct-findings-radiologic-pathologic-correlation-and-imaging-predictors-of-survival-for-patients-with-interstitial-pneumonia-with-autoimmune-features
#13
Jonathan H Chung, Steven M Montner, Ayodeji Adegunsoye, Cathryn Lee, Justin M Oldham, Aliya N Husain, Heber MacMahon, Imre Noth, Rekha Vij, Mary E Strek
OBJECTIVE: The objective of this study is to determine the CT findings and patterns of interstitial pneumonia with autoimmune features (IPAF) and to assess whether imaging can predict survival for patients with IPAF. MATERIALS AND METHODS: The study included 136 subjects who met the criteria for IPAF and had diagnostic-quality chest CT scans obtained from 2006 to 2015; a total of 74 of these subjects had pathologic samples available for review within 1 year of chest CT examination...
March 28, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28300574/sex-steroid-receptor-expression-in-idiopathic-pulmonary-fibrosis
#14
Mitra Mehrad, Humberto E Trejo Bittar, Samuel A Yousem
Usual interstitial pneumonia (UIP) is characterized by progressive scarring of the lungs and is associated with high morbidity and mortality despite therapeutic interventions. Sex steroid receptors have been demonstrated to play an important role in chronic lung conditions; however, their significance is unknown in patients with UIP. We retrospectively reviewed 40 idiopathic UIP cases for the expression of hormonal receptors. Forty cases including 10 normal lung, 10 cryptogenic organizing pneumonia (COP), 10 idiopathic organizing diffuse alveolar damage (DAD), 7 hypersensitivity pneumonitis (HP) and 3 nonspecific interstitial pneumonitis (NSIP) served as controls...
March 11, 2017: Human Pathology
https://www.readbyqxmd.com/read/28297158/unclassifiable-interstitial-lung-diseases-clinical-characteristics-and-survival
#15
Charlotte Hyldgaard, Elisabeth Bendstrup, Athol U Wells, Ole Hilberg
BACKGROUND AND OBJECTIVE: Unclassifiable disease in chronic interstitial lung disease (ILD) is a common and challenging problem but has been insufficiently studied. The 2013 update of the international multidisciplinary classification of the idiopathic interstitial pneumonias presented a classification based on observed disease behaviour with the purpose of providing guidance to clinicians in the management of these patients. The aim of this study was to apply the new disease behaviour classification (DBC) and the previously validated ILD-gender age physiology (GAP) score to a cohort of unclassifiable ILD patients and to assess the prognostic value of these two composite approaches...
April 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28288233/-dress-syndrome-in-paediatrics-clinical-case
#16
Marcos Silva-Feistner, Elena Ortiz, María Jesús Rojas-Lechuga, Daniel Muñoz
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, potentially life-threatening, drug-induced hypersensitivity reaction that includes skin eruption, haematological abnormalities, lymphadenopathy, and internal organ involvement. OBJECTIVE: Presenting a rare condition in children, to facilitate a rapid diagnostic suspicion and recognition by doctors. CASE REPORT: An 9 months old infant admitted due to a severe viral pneumonia, managed with non-invasive ventilation and ceftriaxone...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28223152/pathological-findings-and-prognosis-in-a-large-prospective-cohort-of-chronic-hypersensitivity-pneumonitis
#17
Ping Wang, Kirk D Jones, Anatoly Urisman, Brett M Elicker, Thomas Urbania, Kerri A Johannson, Deborah Assayag, Joyce Lee, Paul J Wolters, Harold R Collard, Laura L Koth
BACKGROUND: The ability of specific histopathological features to predict mortality or lung transplant in chronic hypersensitivity pneumonitis patients is unknown. METHODS: Patients with chronic hypersensitivity pneumonitis diagnosed by surgical lung biopsy were identified from an ongoing longitudinal cohort. The surgical lung biopsy slides were evaluated prospectively by an experienced thoracic pathologist using a standardized checklist to differentiate the major pathologic patterns and score the presence of specific histopathological features...
February 18, 2017: Chest
https://www.readbyqxmd.com/read/28202030/upregulation-of-interleukin-33-and-thymic-stromal-lymphopoietin-levels-in-the-lungs-of-idiopathic-pulmonary-fibrosis
#18
Jong-Uk Lee, Hun Soo Chang, Hyeon Ju Lee, Chang An Jung, Da Jeong Bae, Hyun Ji Song, Jong Sook Park, Soo-Taek Uh, Young Hoon Kim, Ki-Hyun Seo, Choon-Sik Park
BACKGROUND: Innate T helper type 2 (Th2) immune responses mediated by interleukin (IL)-33, thymic stromal lymphopoietin (TSLP), and IL-25 have been shown to play an important role in pulmonary fibrosis of animal models; however, their clinical implications remain poorly understood. METHODS: TSLP, IL-25, and IL-33 concentrations were measured in bronchoalveolar lavage fluids obtained from normal controls (NCs; n = 40) and from patients with idiopathic pulmonary fibrosis (IPF; n = 100), non-specific interstitial pneumonia (NSIP; n = 22), hypersensitivity pneumonitis (HP; n = 20), and sarcoidosis (n = 19)...
February 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28198728/personalized-medicine-in-interstitial-lung-diseases
#19
Paolo Spagnolo, Justin M Oldham, Mark G Jones, Joyce S Lee
PURPOSE OF REVIEW: A number of recent studies have explored the possibility to apply personalized medicine to interstitial lung diseases (ILDs), particularly idiopathic pulmonary fibrosis (IPF), the most common and deadly of the idiopathic interstitial pneumonias. In our review, we summarize and discuss the most recent literature on personalized medicine in IPF as well as hypersensitivity pneumonitis and sarcoidosis, with emphasis on patient subgroups for which a personalized approach to disease prognostication and management may become a reality in the near future...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28182861/diffuse-pulmonary-ossification-in-fibrosing-interstitial-lung-diseases-prevalence-and-associations
#20
Ryoko Egashira, Joseph Jacob, Maria A Kokosi, Anne-Laure Brun, Alexandra Rice, Andrew G Nicholson, Athol U Wells, David M Hansell
Purpose To investigate the prevalence of diffuse pulmonary ossification (DPO) in patients with fibrosing interstitial lung disease (ILD) and determine whether there are differences among the types of ILDs. Materials and Methods Institutional review board approval was given and patient consent was not required for this study. The study population comprised 892 consecutive patients with fibrosing ILD, including 456 patients with idiopathic pulmonary fibrosis (IPF) (men, 366; women, 90; median age, 72 years [range, 38-93 years]), 244 with nonspecific interstitial pneumonia (men, 79; women, 165; median age, 60...
July 2017: Radiology
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