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Schwartbeck B, Rumpf C, Hait R, Decker C, Janssen T, Romme K, Dübbers A, Küster P, Graepler-Mainka U, Hebestreit H, Van-Koningsbruggen-Rietschel S, Renner S, Wollschläger B, Naehrig S, Stehling F, Schlegtendahl A, Ballmann M, Junge S, Sutharsan S, Kahl B. 536 Not only 5–base pair deletions in the intergenic region of the intercellular adhesion operon, but also mutations in the repressor of the intercellular adhesion operon lead to a mucoid phenotype in Staphylococcus aureus residing in the airways of people with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Rumpf C, Schwartbeck B, Hait R, Deiwick S, Decker C, Romme K, Dübbers A, Küster P, Graepler-Mainka U, Hebestreit H, van Koningsbruggen-Rietschel S, Renner S, Wollschläger B, Naehrig S, Sterling F, Schlegtendal A, Sutharsan S, Ballmann M, Junge S, Kahl B. ePS3.01 Preliminary results of an ongoing study, which determines the prevalence and possible impact of mucoid Staphylococcus aureus on lung disease of people with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00299-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Eisenmann S, Stangl F, Lambrecht N, Wollschläger B, Böhm S, Brill R, Vogt I, Baust H, Bucher M, Wohlgemuth WA. Interventional Radiology and Pulmonology in Life-Threatening Aneurysm of the Left Pulmonary Artery. Am J Respir Crit Care Med 2021; 203:366-367. [PMID: 33058729 DOI: 10.1164/rccm.202008-3263im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Franz Stangl
- Department of Diagnostic and Interventional Radiology, and.,Department of Anaesthesiology, University Hospital Halle, Halle, Germany; and
| | | | | | | | - Richard Brill
- Department of Diagnostic and Interventional Radiology, and
| | | | - Henning Baust
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany
| | - Michael Bucher
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany
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Schwarz C, Schulte-Hubbert B, Bend J, Abele-Horn M, Baumann I, Bremer W, Brunsmann F, Dieninghoff D, Eickmeier O, Ellemunter H, Fischer R, Grosse-Onnebrink J, Hammermann J, Hebestreit H, Hogardt M, Hügel C, Hug M, Illing S, Jung A, Kahl B, Koitschev A, Mahlberg R, Mainz JG, Mattner F, Mehl A, Möller A, Muche-Borowski C, Nüßlein T, Puderbach M, Renner S, Rietschel E, Ringshausen FC, Schmidt S, Sedlacek L, Sitter H, Smaczny C, Tümmler B, Vonberg R, Wielpütz MO, Wilkens H, Wollschläger B, Zerlik J, Düesberg U, van Koningsbruggen-Rietschel S. [CF Lung Disease - a German S3 Guideline: Module 2: Diagnostics and Treatment in Chronic Infection with Pseudomonas aeruginosa]. Pneumologie 2018; 72:347-392. [PMID: 29758578 DOI: 10.1055/s-0044-100191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Cystic Fibrosis (CF) is the most common autosomal-recessive genetic disease affecting approximately 8000 people in Germany. The disease is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene leading to dysfunction of CFTR, a transmembrane chloride channel. This defect causes insufficient hydration of the epithelial lining fluid which leads to chronic inflammation of the airways. Recurrent infections of the airways as well as pulmonary exacerbations aggravate chronic inflammation, lead to pulmonary fibrosis and tissue destruction up to global respiratory insufficiency, which is responsible for the mortality in over 90 % of patients. The main aim of pulmonary treatment in CF is to reduce pulmonary inflammation and chronic infection. Pseudomonas aeruginosa (Pa) is the most relevant pathogen in the course of CF lung disease. Colonization and chronic infection are leading to additional loss of pulmonary function. There are many possibilities to treat Pa-infection. This is a S3-clinical guideline which implements a definition for chronic Pa-infection and demonstrates evidence-based diagnostic methods and medical treatment for Pa-infection in order to give guidance for individual treatment options.
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Affiliation(s)
- C Schwarz
- Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Christiane Herzog Zentrum, Berlin
| | - B Schulte-Hubbert
- Medizinische Klinik und Poliklinik I, Pneumologie, Universitätsklinikum Dresden
| | - J Bend
- Mukoviszidose Institut, Bonn
| | - M Abele-Horn
- Universität Würzburg, Institut für Hygiene und Mikrobiologie
| | - I Baumann
- Universität Heidelberg, Hals-Nasen-Ohrenklinik, Heidelberg
| | | | - F Brunsmann
- Charité Universitätsmedizin Berlin, Deutschland (Patientenvertreter)
| | - D Dieninghoff
- Kliniken der Stadt Köln, Lungenklinik, Lehrstuhl der Universität Witten Herdecke
| | - O Eickmeier
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Christiane Herzog CF-Zentrum, Frankfurt
| | - H Ellemunter
- Tirolkliniken GmbH, Department für Kinderheilkunde Pädiatrie III, Innsbruck, Österreich
| | - R Fischer
- Zentrum für erwachsene Mukoviszidose-Patienten München-West
| | - J Grosse-Onnebrink
- Universitätsklinikum Münster UKM; Klinik für Kinder- und Jugendmedizin; Allgemeine Pädiatrie Mukoviszidose-Ambulanz, Münster
| | - J Hammermann
- Universitäts-Mukoviszidose-Zentrum "Christiane Herzog", Dresden
| | | | - M Hogardt
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Frankfurt
| | - C Hügel
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Zentrum der Inneren Medizin, Frankfurt, Deutschland
| | - M Hug
- Universitätsklinikum Freiburg, Apotheke des Klinikums Freiburg
| | - S Illing
- Olgahospital - Kinderklinik - CF-Zentrum/Jugendliche/Erwachsene Stuttgart
| | - A Jung
- Kinderspital Zürich, Abteilung Pneumologie, Zürich, Schweiz
| | - B Kahl
- Universitätsklinikum Münster UKM, Institut für Medizinische Mikrobiologie, Münster
| | - A Koitschev
- Klinikum Stuttgart - Standort Olgahospital, Klinik für Hals-Nasen-Ohrenkrankheiten, Stuttgart
| | - R Mahlberg
- Klinikum Mutterhaus der Borromäerinnen, Abteilung Innere Medizin, Trier
| | - J G Mainz
- Universitätsklinikum Jena, Mukoviszidosezentrum/Pädiatrische Pneumologie, Jena
| | - F Mattner
- Kliniken der Stadt Köln, Institut für Hygiene, Köln
| | - A Mehl
- Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Christiane Herzog Zentrum, Berlin
| | - A Möller
- Pneumologie und CF Ambulanz der Universitäts-Kinderklinik Zürich, Schweiz
| | - C Muche-Borowski
- Philipps-Universität Marburg, AWMF-Institut für Medizinisches Wissensmanagement, Marburg und Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin, Hamburg
| | - T Nüßlein
- Gemeinschaftsklinikum Mittelrhein, Klinik für Kinder- und Jugendmedizin Koblenz und Mayen
| | - M Puderbach
- Hufeland Klinikum, Abteilung für Diagnostische und Interventionelle Radiologie, Bad Langensalza
| | - S Renner
- Allgemeines Universitätskrankenhaus, Klinik für Kinder- und Jugendheilkunde, CF Ambulanz, Wien, Österreich
| | - E Rietschel
- Mukoviszidose-Zentrum Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln
| | - F C Ringshausen
- Medizinische Hochschule Hannover, Klinik für Pneumologie und Deutsches Zentrum für Lungenforschung (DZL), Hannover
| | - S Schmidt
- Ernst-Moritz-Arndt Universität Greifswald, Zentrum für Kinder- und Jugendmedizin; Mukoviszidose Zentrum Mecklenburg/Vorpommern, Greifswald
| | - L Sedlacek
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover
| | - H Sitter
- Philipps-Universität Marburg, Institut für theoretische Medizin, Marburg
| | - C Smaczny
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Zentrum der Inneren Medizin, Frankfurt, Deutschland
| | - B Tümmler
- Medizinische Hochschule Hannover, Klinische Forschergruppe OE 6710, Klinik für Pädiatrische Pneumologie und Neonatologie
| | - R Vonberg
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover
| | - M O Wielpütz
- Diagnostische und Interventionelle Radiologie Universitätsklinikum Heidelberg, Heidelberg
| | - H Wilkens
- Universitätsklinikum des Saarlandes, Medizinische Klinik V, Pneumologie, Allergologie und Beatmungsmedizin, Homburg
| | - B Wollschläger
- Martin-Luther-Universität Halle, Universitätsklinik und Poliklinik für Innere Medizin I/Pneumologie, Halle
| | - J Zerlik
- Altonaer Kinderkrankenhaus gGmbH, Abteilung Physiotherapie, Hamburg
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Schmidt B, Wollschläger B, Reindl I, Lambrecht N, Eisenmann S, Arslan E, Reinicke D, Fleischhacker M. Liquid Biopsy bei Lungenkarzinom-Patienten – Untersuchungen zur Standardisierung der Präanalytik. Pneumologie 2018. [DOI: 10.1055/s-0037-1619212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- B Schmidt
- Pneumologie, DRK Kliniken Berlin
- Mitte
| | | | - I Reindl
- Pneumologie, Universitätsklinikum Halle (Saale)
| | - N Lambrecht
- Pneumologie, Universitätsklinikum Halle (Saale)
| | - S Eisenmann
- Pneumologie, Universitätsklinikum Halle (Saale)
| | - E Arslan
- Schwerpunkt Pneumologie und Schlafmedizin, Klinik für Innere Medizin, DRK-Kliniken Berlin
- Mitte
| | - D Reinicke
- Pneumologie, Universitätsklinikum Halle (Saale)
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Otterbach M, Schmidt B, Wollschläger B. Nutzen und Belastung der verschiedenen Therapieformen für erwachsene CF-Patienten-Evaluation mittels Fragebogen. Pneumologie 2018. [DOI: 10.1055/s-0037-1619209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Otterbach
- Institut für Diagnostische u. Interventionelle Radiologie, Klinikum Oldenburg AöR
| | - B Schmidt
- Pneumologie, DRK Kliniken Berlin
- Mitte
| | - B Wollschläger
- Pneumologie, Klinik für Innere Medizin I, Universitätsklinikum Halle
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Röder C, Wollschläger B. Die Bedeutung des Glycinstoffwechsels für die Lungenfunktion. Pneumologie 2018. [DOI: 10.1055/s-0037-1619162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C Röder
- Universitätsklinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle/Saale
| | - B Wollschläger
- Universitätsklinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle/Saale
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Schmidt B, Reinicke D, Reindl I, Bork I, Wollschläger B, Lambrecht N, Fleischhacker M. Corrigendum to "Liquid biopsy - Performance of the PAXgene® Blood ccfDNA Tubes for the isolation and characterization of cell-free plasma DNA from tumor patients" [Clin. Chim. Acta 469 (2017) 94-98]. Clin Chim Acta 2017; 469:208. [PMID: 28477842 DOI: 10.1016/j.cca.2017.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Bernd Schmidt
- DRK Kliniken Berlin/Mitte, Klinik für Innere Medizin - Schwerpunkt Pneumologie und Schlafmedizin, Drontheimer Straße 39-40, 13359 Berlin, Germany
| | - Dana Reinicke
- Universitätsklinikum Halle/Saale, Klinik f. Innere Medizin, Abtlg. Pneumologie, Ernst Grube Str. 40, 06120 Halle/Saale, Germany
| | - Iris Reindl
- Universitätsklinikum Halle/Saale, Klinik f. Innere Medizin, Abtlg. Pneumologie, Ernst Grube Str. 40, 06120 Halle/Saale, Germany
| | - Ines Bork
- Universitätsklinikum Halle/Saale, Klinik f. Innere Medizin, Abtlg. Pneumologie, Ernst Grube Str. 40, 06120 Halle/Saale, Germany
| | - Bettina Wollschläger
- Universitätsklinikum Halle/Saale, Klinik f. Innere Medizin, Abtlg. Pneumologie, Ernst Grube Str. 40, 06120 Halle/Saale, Germany
| | - Nina Lambrecht
- Universitätsklinikum Halle/Saale, Klinik f. Innere Medizin, Abtlg. Pneumologie, Ernst Grube Str. 40, 06120 Halle/Saale, Germany
| | - Michael Fleischhacker
- Universitätsklinikum Halle/Saale, Klinik f. Innere Medizin, Abtlg. Pneumologie, Ernst Grube Str. 40, 06120 Halle/Saale, Germany.
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Reindl I, Bork I, Lambrecht N, Noack F, Rolke H, Wollschläger B. Systemerkrankung Sarkoidose – über den Tellerrand geschaut. Pneumologie 2017. [DOI: 10.1055/s-0037-1598534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- I Reindl
- Klinik für Innere Medizin I, Universitätsklinikum Halle
| | - I Bork
- Klinik für Innere Medizin I, Universitätsklinikum Halle
| | - N Lambrecht
- Klinik für Innere Medizin I, Universitätsklinikum Halle
| | - F Noack
- Klinik für Innere Medizin I, Universitätsklinikum Halle
| | - H Rolke
- Klinik für Innere Medizin I, Universitätsklinikum Halle
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10
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Lambrecht N, Reindl I, Rolke H, Bork I, Patrick M, Wollschläger B. Unterschätztes Risiko – Influenza in Schwangerschaft und Wochenbett. Pneumologie 2017. [DOI: 10.1055/s-0037-1598446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N Lambrecht
- Abteilung Pneumologie, Klinik für Innere Medizin I, Universitätsklinikum Halle (Saale)
| | - I Reindl
- Abteilung Pneumologie, Klinik für Innere Medizin I, Universitätsklinikum Halle (Saale)
| | - H Rolke
- Abteilung Pneumologie, Klinik für Innere Medizin I, Universitätsklinikum Halle (Saale)
| | - I Bork
- Abteilung Pneumologie, Klinik für Innere Medizin I, Universitätsklinikum Halle (Saale)
| | - M Patrick
- Abteilung Pneumologie, Klinik für Innere Medizin I, Universitätsklinikum Halle (Saale)
| | - B Wollschläger
- Abteilung Pneumologie, Klinik für Innere Medizin I, Universitätsklinikum Halle (Saale)
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Wollschläger B, Bork I, Lambrecht N, Noack F, Reindl I, Rolke H. Infizierte bronchogene Zyste als differentialdiagnostische Herausforderung bei einer 40-jährigen CF-Patientin. Pneumologie 2017. [DOI: 10.1055/s-0037-1598533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - I Bork
- Klinik für Innere Medizin I, Universitätsklinikum Halle
| | - N Lambrecht
- Klinik für Innere Medizin I, Universitätsklinikum Halle
| | - F Noack
- Klinik für Innere Medizin I, Universitätsklinikum Halle
| | - I Reindl
- Klinik für Innere Medizin I, Universitätsklinikum Halle
| | - H Rolke
- Klinik für Innere Medizin I, Universitätsklinikum Halle
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Reindl I, Lambrecht N, Bork I, Röder C, Rolke H, Noack F, Wollschläger B. Suchet, so werdet ihr finden – 2 Fälle von sekundärem Pleuraempyem. Pneumologie 2016; 70:826-830. [DOI: 10.1055/s-0036-1596080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- I Reindl
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle
| | - N Lambrecht
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle
| | - I Bork
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle
| | - C Röder
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle
| | - H Rolke
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle
| | - F Noack
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle
| | - B Wollschläger
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle
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Junge S, Görlich D, den Reijer M, Wiedemann B, Tümmler B, Ellemunter H, Dübbers A, Küster P, Ballmann M, Koerner-Rettberg C, Große-Onnebrink J, Heuer E, Sextro W, Mainz JG, Hammermann J, Riethmüller J, Graepler-Mainka U, Staab D, Wollschläger B, Szczepanski R, Schuster A, Tegtmeyer FK, Sutharsan S, Wald A, Nofer JR, van Wamel W, Becker K, Peters G, Kahl BC. Factors Associated with Worse Lung Function in Cystic Fibrosis Patients with Persistent Staphylococcus aureus. PLoS One 2016; 11:e0166220. [PMID: 27861524 PMCID: PMC5115705 DOI: 10.1371/journal.pone.0166220] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 10/25/2016] [Indexed: 01/04/2023] Open
Abstract
Background Staphylococcus aureus is an important pathogen in cystic fibrosis (CF). However, it is not clear which factors are associated with worse lung function in patients with persistent S. aureus airway cultures. Our main hypothesis was that patients with high S. aureus density in their respiratory specimens would more likely experience worsening of their lung disease than patients with low bacterial loads. Methods Therefore, we conducted an observational prospective longitudinal multi-center study and assessed the association between lung function and S. aureus bacterial density in respiratory samples, co-infection with other CF-pathogens, nasal S. aureus carriage, clinical status, antibiotic therapy, IL-6- and IgG-levels against S. aureus virulence factors. Results 195 patients from 17 centers were followed; each patient had an average of 7 visits. Data were analyzed using descriptive statistics and generalized linear mixed models. Our main hypothesis was only supported for patients providing throat specimens indicating that patients with higher density experienced a steeper lung function decline (p<0.001). Patients with exacerbations (n = 60), S. aureus small-colony variants (SCVs, n = 84) and co-infection with Stenotrophomonas maltophilia (n = 44) had worse lung function (p = 0.0068; p = 0.0011; p = 0.0103). Patients with SCVs were older (p = 0.0066) and more often treated with trimethoprim/sulfamethoxazole (p = 0.0078). IL-6 levels positively correlated with decreased lung function (p<0.001), S. aureus density in sputa (p = 0.0016), SCVs (p = 0.0209), exacerbations (p = 0.0041) and co-infections with S. maltophilia (p = 0.0195) or A. fumigatus (p = 0.0496). Conclusions In CF-patients with chronic S. aureus cultures, independent risk factors for worse lung function are high bacterial density in throat cultures, exacerbations, elevated IL-6 levels, presence of S. aureus SCVs and co-infection with S. maltophilia. Trial Registration ClinicalTrials.gov NCT00669760
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Affiliation(s)
- Sibylle Junge
- Clinic for Paediatric Pulmonology, Allergology and Neonatology, Hannover, Hannover, Germany
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research, University Hospital Münster, Münster, Germany
| | - Martijn den Reijer
- Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bärbel Wiedemann
- Institute of Medical Informatics and Biometrics, Technical University Dresden, Dresden, Germany
| | - Burkhard Tümmler
- Clinical Research Group, Clinic for Paediatric Pulmonology, Allergology and Neonatology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Helmut Ellemunter
- CF-Center Innsbruck, Department of Child and Adolescent Health, Medical University of Innsbruck, Innsbruck, Austria
| | - Angelika Dübbers
- Department of Paediatrics, University Hospital Münster, Münster, Germany
| | - Peter Küster
- Department of Paediatrics, Clemenshospital Münster, Münster, Germany
| | - Manfred Ballmann
- Ruhr University, Paediatric Clinic at St Josef Hospital, Bochum, Germany
| | | | | | | | | | - Jochen G. Mainz
- CF Center, Department of Paediatrics, Jena University Hospital, Jena, Germany
| | - Jutta Hammermann
- Department of Paediatrics, University Clinics Dresden, Dresden, Germany
| | | | | | - Doris Staab
- Department of Paediatric Pulmonology and Immunology, Charité Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
| | | | | | - Antje Schuster
- Department of Paediatrics, University of Düsseldorf, Düsseldorf, Germany
| | | | | | | | - Jerzy-Roch Nofer
- Center for Laboratory Medicine, University Hospital Münster, Münster, Germany
| | - Willem van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Karsten Becker
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Georg Peters
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Barbara C. Kahl
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
- * E-mail:
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Frenzen F, Röder C, Wollschläger B, Großer E, Krohe K, Schmidt B. [Pichia guilliermondii Infection - A Rare Differential Diagnosis of Pulmonary Nodules]. Pneumologie 2016; 70:605-7. [PMID: 27603949 DOI: 10.1055/s-0042-112898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
UNLABELLED A patient presented himself with pungent, breath-dependent right chest pain and dyspnea at rest in our emergency department. The physical examination and the ECG revealed no relevant findings. The laboratory results showed an increased CRP, leukocytosis, elevated D-dimers and a respiratory partial insufficiency. In the thoracic CT angiography unclear pulmonary nodules (PN) were seen. The bronchoscopy was macroscopically normal. In the BAL yeasts and a high proportion of immune senescence cells (CD57+) were identified. After a pulmonary wedge resection resulted histologically an epithelioid cell-granulomatous inflammation. Molecular pathological a mycelium genome, in particular Pichia guilliermondii (PC) was detected. The therapy with fluconazole was successful. PC rarely causes candidemia, increased in immunocompromised patients. In our judgement this is in Europe the first described case of PC-infection in a patient, which presented no predisposition to infection with opportunistic pathogens apart from type 2 diabetes. CONCLUSION It should be thought of fungal infection by these pathogens group in case of unclear PN, especially in combination with possibly predisposing factors.
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Affiliation(s)
- F Frenzen
- Universitätsklinik und Poliklinik für Innere Medizin I, Schwerpunkt Pneumologie
| | - C Röder
- Universitätsklinik und Poliklinik für Innere Medizin I, Schwerpunkt Pneumologie
| | - B Wollschläger
- Universitätsklinik und Poliklinik für Innere Medizin I, Schwerpunkt Pneumologie
| | | | - K Krohe
- Universitätsklinik und Poliklinik für Herz- und Thorax-Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale)
| | - B Schmidt
- Universitätsklinik und Poliklinik für Innere Medizin I, Schwerpunkt Pneumologie
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Rolke H, Oerding C, Lambrecht N, Reindl I, Bork I, Wollschläger B, Fleischhacker M, Schmidt B. Liquid biopsy: Vergleichende Untersuchungen zur Isolation von zirkulierenden Tumorzellen (CTC) mittels des CellCollectors in vitro und in vivo. Pneumologie 2016. [DOI: 10.1055/s-0036-1571965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Wollschläger B, Bork I, Lambrecht N, Noack F, Reindl I, Röder C, Rolke H, Schmidt B. Mutationsspezifische Therapie der Mukoviszidose mit Ivacaftor – Erfahrungen der CF-Ambulanz Halle mit erwachsenen CF-Patienten. Pneumologie 2016. [DOI: 10.1055/s-0036-1572076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Reindl I, Bork I, Rolke H, Lambrecht N, Röder C, Wollschläger B, Schmidt B. Fallbericht – schwerster Verlauf einer kardialen Sarkoidose. Pneumologie 2016. [DOI: 10.1055/s-0036-1572214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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18
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Frenzen F, Röder C, Wollschläger B, Lupatsch F, Krohe K, Schmidt B. Eine seltene Differentialdiagnose bei pulmonalen Rundherden – Die Pulmonale Pichia guillermondii-Infektion. Pneumologie 2016. [DOI: 10.1055/s-0036-1572217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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19
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Reindl I, Bork I, Lambrecht N, Röder C, Rolke H, Wollschläger B, Schmidt B. Fallbericht – schwerster Verlauf einer kardialen Sarkoidose. Pneumologie 2016. [DOI: 10.1055/s-0036-1572175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Lambrecht N, Reindl I, Bork I, Rolke H, Röder C, Wollschläger B. Fallbericht – Pneumonie mit Folgen. Pneumologie 2016. [DOI: 10.1055/s-0036-1572174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Wollschläger B, Bork I, Franke U, Lambrecht N, Noack F, Reindl I, Röder C, Schmidt B. Destruktion der Trachealwand: Manche Fälle bleiben ungelöst, andere nicht. Pneumologie 2015. [DOI: 10.1055/s-0035-1544751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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22
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Wollschläger B, Bork I, Franke U, Lambrecht N, Noack F, Röder C, Reindl I, Kreft B, Lange D, Schmidt B. Hätten Sie eine pulmonale Tuberkulose erwartet? Rekonstitutionssyndrom im Rahmen einer Miliartuberkulose bei HIV. Pneumologie 2015. [DOI: 10.1055/s-0035-1544798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Fleischhacker M, Rehbein G, Schmidt B, Wollschläger B. MicroRNAs als Lungenkarzinom-Marker in der Bronchial-Lavage. Pneumologie 2015. [DOI: 10.1055/s-0035-1544726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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24
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Röder C, Bork I, Böhm S, Wollschläger B, Schmidt B. Hämoptysen – Der besondere Fall einer Tropischen Lungeneosinophilie. Pneumologie 2014. [DOI: 10.1055/s-0033-1364144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Greinert R, Greinert D, Noack F, Wollschläger B, Schmidt B. Pulmonale Kaverne – ein überraschender histologischer Befund. Pneumologie 2014. [DOI: 10.1055/s-0033-1364135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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26
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Wollschläger B, Bork I, Noack F, Reindl I, Krohe K, Schmidt B. Ultima ratio Stent. Pneumologie 2014. [DOI: 10.1055/s-0033-1364145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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27
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Bork I, Wollschläger B, Reindl I, Schmidt B. Ein zu erwartender Verlauf? Pneumologie 2014. [DOI: 10.1055/s-0034-1367980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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28
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Röder C, Bork I, Wollschläger B, Schmidt B. Die Tropische Lungeneosinophilie kann auch in Deutschland vorkommen – ein ungewöhnlicher Fall. Pneumologie 2014. [DOI: 10.1055/s-0034-1368011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Wollschläger B, Bork I, Franke U, Röder C, Reindl I, Noack F, Schmidt B. Komplikationsreicher Verlauf nach Lungentransplantation bei einer Mukoviszidosepatientin. Pneumologie 2014. [DOI: 10.1055/s-0034-1368015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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30
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Pfaff F, Wollschläger B, Bork I, Reindl I, Schmidt B. Mikrobiologische Befunde in der Bronchoskopie: Ein Vergleich oraler Mikroorganismen mit Lavageergebnissen der Bronchoskopie. Pneumologie 2014. [DOI: 10.1055/s-0034-1367821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Wollschläger B, Bork I, Franke U, Röder C, Reindl I, Noack F, Brandt S, Krohe K, Steinke T, Wagner B, Schmidt B. Pulmonalarterienatresie –- eine seltene Ursache für Haemoptoe. Pneumologie 2014. [DOI: 10.1055/s-0034-1368009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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32
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Bach AG, Wollschläger B, Holzhausen HJ, Surov A. [Increased dyspnea after airbag rupture]. ROFO-FORTSCHR RONTG 2013; 186:803-4. [PMID: 24347357 DOI: 10.1055/s-0033-1356144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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33
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Junge S, Wiedemann B, Tümmler B, Dübbers A, Küster P, Nofer J, Ellemunter H, Mainz J, Heuer E, Sextro W, Körner-Rettberg C, Ballmann M, Mellies U, Hammermann J, Teschler H, Szczepanski R, Tegtmeyer F, Graepler-Mainka U, Riethmueller J, Wald A, Wollschläger B, Staab D, Schuster A, Becker K, Peters G, Kahl B. WS19.9 A prospective multicenter study to dissect Staphylococcus aureus-colonization from infection in cystic fibrosis patients. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60122-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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34
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Fleischhacker M, Rolke H, Theil G, Haubold K, Morgenthaler N, Wollschläger B, Bork I, Schmidt B. Isolation von zirkulierenden Tumorzellen (CTC) bei Lungenkarzinompatienten mithilfe eines CellCollectors - erste Pilotuntersuchungen. Pneumologie 2013. [DOI: 10.1055/s-0033-1334770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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35
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Röder C, Wollschläger B, Schmidt B, Werdan K. Eine einseitige Zwerchfellparese und eine superfizielle zerebrale Hämosiderose - als Manifestation einer Neuro-Sarkoidose? Wenn die Sarkoidose „nur“ auf Herz und Nerven geht. Pneumologie 2013. [DOI: 10.1055/s-0033-1334540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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36
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Wollschläger B, Bork I, Franke U, Noack F, Schmidt B. Mukoviszidose-Diagnose im Erwachsenenalter – Erfahrungen des Mukoviszidose-Zentrums Halle. Pneumologie 2012. [DOI: 10.1055/s-0032-1302697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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37
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Noack F, Schlitt A, Köhler S, Schleife K, Wehnert T, Hollenbach M, Franke U, Bork I, Wollschläger B, Schmidt B. Ist die systolische Rechtsherzfunktion ein Prädiktor für die kardiopulmonale Leistungsfähigkeit? Pneumologie 2012. [DOI: 10.1055/s-0032-1302693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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38
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Franke U, Noack F, Bork I, Wollschläger B, Schmidt B, Stiller D, Ebelt H. Ehlers-Danlos-Sydrom und ausgeprägte pulmonale Hypertonie bei rezidivierenden Thrombembolien. Pneumologie 2012. [DOI: 10.1055/s-0032-1302875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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39
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Franke U, Noack F, Bork I, Wollschläger B, Schmidt B, Ebelt H. Das Auftreten eines diffusen alveolären Hämorrhagiesyndroms mit nachfolgendem akuten Lungenversagen als Erstsymptom eines M. Wegener. Pneumologie 2012. [DOI: 10.1055/s-0032-1302578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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40
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Wollschläger B, Noack F, Bork I, Schmidt B. Hätten Sie daran gedacht? CF-Diagnose jenseits des 40. Lebensjahres. Pneumologie 2011. [DOI: 10.1055/s-0031-1297389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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41
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Wollschläger B, Bork I, Noack F, Berger A, Schmidt B. Späte CF-Diagnose jenseits des 40. Lebensjahres - drei Fallberichte. Pneumologie 2011. [DOI: 10.1055/s-0031-1272072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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42
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Noack F, Bork I, Hollenbach M, Berger A, Wollschläger B, Seufferlein T, Schmidt B. Große rechtsventrikuläre Metastase als seltene Dyspnoeursache beim nicht-kleinzelligen Lungenkarzinom. Pneumologie 2011. [DOI: 10.1055/s-0031-1272184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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43
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Noack F, Bork I, Wollschläger B, Seufferlein T, Schmidt B. Transfusionspflichtige periphere pulmonale Blutung als einzige Manifestation eines B-NHL. Pneumologie 2011. [DOI: 10.1055/s-0031-1272299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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44
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Bensel T, Stotz M, Borneff-Lipp M, Wollschläger B, Wienke A, Taccetti G, Campana S, Meyer KC, Jensen PØ, Lechner U, Ulrich M, Döring G, Worlitzsch D. Lactate in cystic fibrosis sputum. J Cyst Fibros 2010; 10:37-44. [PMID: 20947455 DOI: 10.1016/j.jcf.2010.09.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 09/16/2010] [Accepted: 09/20/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND Antibiotic therapy is thought to improve lung function in patients with cystic fibrosis (CF) by decreasing neutrophil-derived inflammation. We investigated the origin and clinical significance of lactate in the chronically inflamed CF lung. METHODS Lactate was measured in sputa of 18 exacerbated and 25 stable CF patients via spectrophotometry and gaschromatography. Lung function was assessed via spirometry. Seven patients with chronic obstructive pulmonary disease (COPD) and three patients with acute lung inflammation served as control groups. Neutrophil and bacterial lactate production was assessed under aerobic and anaerobic conditions. RESULTS In sputum specimens of patients with respiratory exacerbations lactate concentrations decreased significantly (p<0.005) from 3.4±2.3mmol/L to 1.4±1.4mmol/L after 2-3 weeks of intravenous antibiotics. Successful treatment was reflected in 16 patients (88.9%) by FVC increase associated with lactate decrease (p<0.05). In every single sputum lactate was detectable (3.0±3.1mmol/L, range 0.2-14.1mmol/L). Lactate was lower (1.6±0.8mmol/L) in sputa from seven COPD patients, and it was below the detection limit in three patients with acute lung inflammation. Neutrophil lactate production accumulated up to 10.5mmol/L after 4 days, whereas bacterial lactate production did not appear to contribute substantially to sputum lactate concentrations. CONCLUSIONS Successful antibiotic therapy is reflected by a decrease in lactate concentrations. Neutrophils are the most likely source for lactate in sputum of CF patients. Therefore lactate may be used to monitor responses to antibiotic therapy as an adjunct to lung function measurements.
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Affiliation(s)
- Tobias Bensel
- Institute of Hygiene, University Hospital of Halle-Wittenberg, Halle, Germany
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45
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Worlitzsch D, Jaschinski A, Bensel T, Wollschläger B, Borneff-Lipp M. Modes of interaction between Pseudomonas aeruginosa and obligate anaerobes. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60119-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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46
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Noack F, Bork I, Lemke J, Krohe K, Wollschläger B, Seufferlein T. Tuberkulose-Reaktivierung in der Thoraxwand 57 Jahre nach operativer Kollapstherapie – differenzialdiagnostische und therapeutische Probleme. Pneumologie 2009. [DOI: 10.1055/s-2009-1242166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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47
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Wollschläger B, Bork I, Lemke J, Noack F, Stock K, Seufferlein T. Thorakales Aortenaneurysma als relevante Differenzialdiagnose einer pulmonalen Raumforderung. Pneumologie 2009. [DOI: 10.1055/s-2009-1242176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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48
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Worlitzsch D, Rintelen C, Böhm K, Wollschläger B, Merkel N, Borneff-Lipp M, Döring G. Antibiotic-resistant obligate anaerobes during exacerbations of cystic fibrosis patients. Clin Microbiol Infect 2009; 15:454-60. [DOI: 10.1111/j.1469-0691.2008.02659.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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49
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Lemke J, Wollschläger B, Bork I, Werdan K. Alveolarproteinose – Zufallsbefund eines seltenen Erkrankungsbildes. Pneumologie 2008. [DOI: 10.1055/s-0028-1096571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Koch AK, Brömme S, Wollschläger B, Horneff G, Keyszer G. Musculoskeletal manifestations and rheumatic symptoms in patients with cystic fibrosis (CF) no observations of CF-specific arthropathy. J Rheumatol 2008; 35:1882-1891. [PMID: 18688909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To determine the character and frequency of musculoskeletal manifestations and rheumatic symptoms in patients with cystic fibrosis (CF). METHODS Rheumatic symptoms and signs of 70 patients with CF (age 6 to 61 yrs) were determined by interview and clinical assessment. Age and sex-matched healthy volunteers served as a control group. In CF patients, laboratory measures and bone mineral density (BMD) were investigated. The data were correlated with the CF phenotype [Shwachman Score (ShS), Chrispin-Norman Score (ChNS), and pulmonary function tests (PFT)]. RESULTS The prevalence of joint pain in the CF patients was 12.9%, with a mean duration of 7 days. Swollen joints were found in 4 patients. None fulfilled the criteria for rheumatoid arthritis or connective tissue disease. Adult CF patients complained more often about noninflammatory back pain and myalgia, and demonstrated reduced spine mobility and impaired everyday life functions compared with the controls. Symptomatic CF patients had elevated erythrocyte sedimentation rate and C-reactive protein levels and performed worse on the ShS, ChNS, and PFT than asymptomatic patients. Antibodies against exotoxin A of Pseudomonas aeruginosa and recombinant Aspergillus fumigatus allergen f4 were found more frequently in CF patients with arthralgia. BMD was decreased in adult patients with more severe CF. CONCLUSION In CF patients, the prevalence of rheumatic symptoms increases with age and CF severity. Our data suggest an association of infections with P. aeruginosa and A. fumigatus with the occurrence of rheumatic symptoms. However, no association of CF with definite inflammatory joint or connective tissue diseases was observed, and no CF-specific pattern of musculoskeletal symptoms was seen.
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Affiliation(s)
- Ann-Kristin Koch
- Department of Internal Medicine I, University Hospital of Martin-Luther University Halle-Wittenberg, Halle Saale, Germany.
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