1/6. common variable immunodeficiency with mosaic trisomy 8: report of one case.This case study reported a 17-year-old female of common variable immunodeficiency (CVID) associated with bronchiectasis, pernicious anemia and mosaic trisomy 8. Clinically this patient presented with recurrent sinopulmonary infections, intractable diarrhea, macrocytic anemia, and primary amenorrhea. Immunological tests showed pan-hypogammaglobulinemia and a decrease of peripheral blood B cells (4%) and CD4 cells (25%). Lymphoproliferative responses to mitogen (PHA) and specific antigen (BCG) were profoundly impaired in the patient in comparison to those in control. Production of interleukin 4 (IL-4) and gamma interferon (IFN-gamma) in the in vitro lymphoproliferation was also profoundly depressed. Pernicious anemia demonstrated by larger MCV (112.9 fl) and hyper-segmental granulocytes on peripheral blood smear responded to parental administration of vitamin B12. Interestingly, she had a mosaic trisomy 8 in peripheral blood mononuclear cells but normal 46XX karyotype in the bone marrow cells. To our knowledge, this is the first case of CVID associated with mosaic trisomy 8 reported in the literature. As the case exemplifies, CVID should be considered when the physicians evaluate the patient presenting with recurrent sinopulmonary infections, diarrhea, malnutrition, and pernicious anemia. It requires further study to explore whether the genes in the chromosome 8 are linked to CVID.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/6. bronchiectasis in a patient with crest syndrome.bronchiectasis is an uncommon pulmonary manifestation of systemic sclerosis (SSc). We report the case of a 70-year-old woman with crest syndrome and vasculitis who developed multifocal symptomatic bronchiectasis. The bronchiectasis and immunosuppressive therapy precipitated severe lower respiratory tract infection, which was fatal within a few months. The concomitant occurrence of bronchiectasis and SSc raises the possibility of a pathophysiological relationship. Several hypotheses can be put forward to explain the occurrence of bronchial wall damage leading to bronchiectasis. Whatever the mechanism, cases of bronchiectasis in patients with SSc should be reported to make physicians aware of the substantial risk associated with this combination.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/6. Bronchial angiography: a report of 21 patients.Angiographic studies of the bronchial and other systemic thoracic arteries were requested by referring physicians in 21 patients, in 18 cases because of hemoptysis. Selective catheterization was carried out in 18 of the 21, and in an additional two patients the bronchial arteries were identified by thoracic aortography. Five examples of effective therapeutic embolization are discussed. Bronchial angiography and embolization appear to be of value in the diagnosis and treatment of hemoptysis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/6. bronchiectasis masquerading as pulmonary embolus.The diagnosis of bronchiectasis usually suggests a patient with a productive cough and shortness of breath. This report describes the case history of an otherwise healthy 43-year-old man who presented with repetitive episodes of pleuritic pain that led to several extensive, invasive evaluations in search of a pulmonary embolus. Only after a carefully taken history did the patient admit to an intermittent chronic cough, which suggested the diagnosis of bronchiectasis. This diagnosis was ultimately confirmed by bronchography. This report suggests that patients with bronchiectasis may present with unusual clinical manifestations, and that the correct diagnosis may be missed unless physicians are aware that "old" diseases may present in "new" ways.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/6. Reversible cystic dilatation of distal airways due to foreign body.We describe a child with foreign body aspiration whose chest radiograph showed an unusual appearance of multiple round lucencies simulating bronchiectasis. This appearance is contrary to the usual appearance of emphysema due to the check-valve type of obstruction. This report is particularly useful for pediatricians and family physicians, who should be aware of the variable appearances of foreign body aspiration. Our case emphasizes the necessity of early bronchoscopy in pediatric patients with unresolving pneumonia.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/6. Perforation of the right ventricle: a complication of blind placement of a chest tube into the postpneumonectomy space.We were asked to review a case from an outside hospital in which there was inadvertent perforation of the right ventricle during the percutaneous placement of a chest tube. We present the case in the hopes that by doing so, others will avoid such a complication in the future. After reviewing the case, it appeared that the complication occurred because the physician was not knowledgeable about the anatomy of the postpneumonectomy space and the physician failed to use the safest procedure in placing the tube.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |