1
|
Youn S, Yang CW, Chung BH, Ko EJ. Newly diagnosed metastatic pulmonary calcification in a kidney transplantation recipient: a case report. KOREAN JOURNAL OF TRANSPLANTATION 2022; 36:278-282. [PMID: 36704806 PMCID: PMC9832592 DOI: 10.4285/kjt.22.0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/14/2022] [Accepted: 08/08/2022] [Indexed: 01/29/2023] Open
Abstract
Metastatic pulmonary calcification (MPC) is defined as calcium deposition in lung tissues. It is commonly seen in end-stage renal disease patients. However, MPC occurring in kidney transplant recipients (KTRs) is rare. We report a case of MPC in a 55-year-old female patient after successful kidney transplantation (KT). One year after KT, bisphosphonate and vitamin D were prescribed for osteoporosis. Then, 4.5 years after KT, we incidentally found multiple nodular lesions on chest X-ray (CXR) without any symptoms. Chest computed tomography showed multiple high-density nodules. A bone scan confirmed MPC in the right middle lobe and right lower lobe. A retrospective review of pretransplant blood chemistry revealed the following: serum calcium level, 11.2 mg/dL; phosphorus level, 3.2 mg/dL; intact parathyroid hormone level, lower than 2.5 pg/mL; and 24-hour urine calcium level, within normal limits (WNL). After KT, all of these parameters remained WNL. Therefore, hidden adynamic bone disease might have been aggravated by bisphosphonate and vitamin D supplementation, causing MPC. Both were discontinued. She was monitored by routine CXR, and MPC did not progress. Since MPC is commonly asymptomatic and difficult to diagnose in KTRs, caution is required when administering such medications. Patient should be followed up with routine CXR.
Collapse
Affiliation(s)
- Sojung Youn
- Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chul Woo Yang
- Transplantation Research Center, Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea,Convergent Research Consortium for Immunologic Disease, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Ha Chung
- Transplantation Research Center, Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea,Convergent Research Consortium for Immunologic Disease, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea,Corresponding author: Byung Ha Chung Transplantation Research Center, Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea, Tel: +82-2-2258-6066, Fax: +82-2-2258-6917, E-mail:
| | - Eun Jeong Ko
- Transplantation Research Center, Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea,Convergent Research Consortium for Immunologic Disease, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea,Co-corresponding author: Eun Jeong Ko, Transplantation Research Center, Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea, Tel: +82-2-2258-6760, Fax: +82-2-2258-6917, E-mail:
| |
Collapse
|
3
|
Cheng Q, Lai X, Yang L, Yang H, Luo Y. Serum CD5L predicts acute lung parenchymal injury and acute respiratory distress syndrome in trauma patients. Medicine (Baltimore) 2021; 100:e27219. [PMID: 34596119 PMCID: PMC8483880 DOI: 10.1097/md.0000000000027219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/26/2021] [Indexed: 01/05/2023] Open
Abstract
Cluster of differentiation 5 antigen-like (CD5L), derived from alveolar epithelial cells partly, is a secreted protein. It is shown that CD5L is associated with lung inflammation and systemic inflammatory diseases, but the relationship between CD5L and trauma-related acute lung parenchymal injury (PLI), acute lung injury or acute respiratory distress syndrome (ARDS) is unclear. This study aims to explore the value of serum CD5L levels in predicting trauma-associated PLI/ARDS and its potential clinical significance.This is a prospective observational study, and a total of 127 trauma patients were recruited from the emergency department (ED), and among them, 81 suffered from PLI/ARDS within 24 hours after trauma, and 46 suffered from trauma without PLI/ARDS. Fifty healthy subjects from the medical examination center were also recruited as controls for comparison. The serum CD5L level was measured within 24 hours of admission. The receiver operating characteristic analysis and logistic regression analysis were used to identify the correlation between high CD5L and trauma associated-PLI/ARDS within 24 hours following trauma.The trauma associated-PLI/ARDS subjects showed a significantly higher level of serum CD5L on emergency department admission within 24 hours after trauma compared with its level in non-trauma associated-PLI/ARDS subjects and healthy subjects. The initial CD5L concentration higher than 150.3 ng/mL was identified as indicating a high risk of PLI/ARDS within 24 hours following trauma (95% confidence interval: 0.674-0.878; P < .001). Moreover, CD5L was an independent risk factor for trauma associated-PLI/ARDS within 24 hours following trauma.CD5L could predict PLI/ARDS within 24 hours following trauma.
Collapse
Affiliation(s)
- Qian Cheng
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuzhong District, Chongqing, China
| | - Xiaofei Lai
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuzhong District, Chongqing, China
| | - Liping Yang
- Department of Laboratory Medicine, Guangyuan Central Hospital, No. 16 Jingxiangzi Road, Lizhou District, Guangyuan City, Sichuan Province, China
| | - Huiqing Yang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuzhong District, Chongqing, China
| | - Yan Luo
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuzhong District, Chongqing, China
| |
Collapse
|
4
|
Follicular Bronchiolitis in a Nigerian Female Child: A Case Report and Review of the Literature. Case Rep Pediatr 2016; 2016:1096953. [PMID: 27313935 PMCID: PMC4899587 DOI: 10.1155/2016/1096953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/04/2016] [Indexed: 11/24/2022] Open
Abstract
Small airways diseases are not uncommon in childhood. They account for about 28.4% of hospital admissions for lower respiratory tract infections in South West Nigeria, most of which are due to respiratory syncytial virus (RSV) infection. Noninfectious causes of small airways diseases, on the other hand, are poorly recognized and rarely feature in the differential diagnoses of chronic/recurrent lower respiratory tract disease in our environment. We present a case of follicular bronchiolitis in a 2.5-year-old Nigerian female who had left upper lobectomy on account of recurrent cough and progressive shortness of breath.
Collapse
|
5
|
Azoulay E. Fibrosing Alveolitis in Hematologic Malignancy Patients Undergoing Hematopoietic Cell Transplantation. PULMONARY INVOLVEMENT IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES 2011. [PMCID: PMC7123073 DOI: 10.1007/978-3-642-15742-4_42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although advances in antineoplastic therapy have considerably improved the survival of patients with hematological malignancies, current treatment modalities increase the risk of late complications. Several forms of chronic pulmonary dysfunction due to infectious or noninfectious causes commonly occur in the months to years after chemo-radiotherapy and can be fatal or result in long-term morbidity. The judicious use of prophylactic antimicrobial agents has tipped the balance toward noninfectious etiologies. Hence, while opportunistic infections still contribute to chronic lung disease, late sequelae resulting from antineoplastic therapy have been identified and reported. Patients who proceed to receive hematopoietic cell transplantation (HSCT) are particularly prone to developing lung complications. Pulmonary dysfunction occurring after HSCT may manifest with obstructive or restrictive pulmonary mechanics and may range in severity from subtle, subclinical functional changes to frank respiratory failure. Insights generated using animal models suggest that the immunologic mechanisms contributing to lung inflammation after HSCT may be similar to those responsible for graft-versus host disease. In sum, chronic fibrotic pulmonary dysfunction is a frequent and significant complication facing survivors of hematologic malignancies and their practitioners. The high incidence and suboptimal response to current support care and immunosuppressive therapy underscore the need for heightened awareness and continued research in this area.
Collapse
Affiliation(s)
- Elie Azoulay
- Service de Réanimation Médicale, Hôpital Saint Louis, Avenue Claude Vellefaux 1, Paris, 75010 France
| |
Collapse
|
7
|
Szakacs JG. Pathologist's approach to diffuse lung disease. Semin Ultrasound CT MR 2002; 23:275-87. [PMID: 12465685 DOI: 10.1016/s0887-2171(02)90017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The pathologic diagnosis of diffuse lung disease is based on the recognition of specific patterns closely correlated with the clinical history and the radiologic findings. The current pathologic classification of the idiopathic interstitial pneumonias is in flux, with the new creation of cellular and fibrotic subtypes of nonspecific interstitial pneumonia and further refinements in the criteria for usual interstitial pneumonia, desquamative interstitial pneumonia, and respiratory bronchiolitis-associated lung disease. The radiologist plays a pivotal role in the diagnosis of these conditions by using high-resolution computed tomography. The radiologist also provides an important service by guiding the clinician or surgeon, based on the site and extent of disease, in obtaining a sample that will provide the pathologist with appropriate diagnostic material. This article reviews the current pathologic criteria for the classification of idiopathic interstitial pneumonias, smoking-related disorders, hypersensitivity pneumonitis, as well as the lymphoproliferative disorder lymphocytic interstitial pneumonitis, with a focus on differential diagnoses.
Collapse
Affiliation(s)
- Juliana G Szakacs
- Department of Pathology, University of Utah, Salt Lake City, UT 84132, USA.
| |
Collapse
|