BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of sec...BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.CASE SUMMARY A 54 years old man,previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy,underwent nine months of antituberculosis treatment.Follow-up lung computed tomography revealed multiple new subpleural groundglass opacities in both lungs,and a lung biopsy confirmed organizing pneumonia.Treatment continued with anti-tuberculosis agents and hormone therapy,and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption.No disease recurrence was observed after corticosteroid therapy discontinuation.CONCLUSION When treating patients with active pulmonary tuberculosis,if an increase in lesions is observed during anti-tuberculosis treatment,it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia,timely lung biopsy is essential for early intervention.展开更多
Eosinophilic esophagitis is an immune-allergic pathology of multifactorial etiology(genetic and environmental)that affects both pediatric and adult patients.Its symptoms,which include heartburn,regurgitation,and esoph...Eosinophilic esophagitis is an immune-allergic pathology of multifactorial etiology(genetic and environmental)that affects both pediatric and adult patients.Its symptoms,which include heartburn,regurgitation,and esophageal stenosis(with dysphagia being more frequent in eosinophilic esophagitis in young adults and children),are similar to those of gastroesophageal reflux disease,causing delays in diagnosis and treatment.Although endoscopic findings such as furrows,esophageal mucosa trachealization,and whitish exudates may suggest its presence,this diagnosis should be confirmed histologically based on the presence of more than 15 eosinophils per high-power field and the exclusion of other causes of eosinophilia(parasitic infections,hypereosinophilic syndrome,inflammatory bowel disease,among others)for which treatment could be initiated.Currently,the 3“D”s(“Drugs,Diet,and Dilation”)are considered the fundamental components of treatment.The first 2 components,which involve the use of proton pump inhibitors,corticosteroids,immunosuppressants and empirical diets or guided food elimination based on allergy tests,are more useful in the initial phases,whereas endoscopic dilation is reserved for esophageal strictures.Herein,the most important aspects of eosinophilic esophagitis pathophysiology will be reviewed,in addition to evidence for the various treatments.展开更多
基金Supported by The Science and Technology Innovation Program of Changde City.
文摘BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.CASE SUMMARY A 54 years old man,previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy,underwent nine months of antituberculosis treatment.Follow-up lung computed tomography revealed multiple new subpleural groundglass opacities in both lungs,and a lung biopsy confirmed organizing pneumonia.Treatment continued with anti-tuberculosis agents and hormone therapy,and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption.No disease recurrence was observed after corticosteroid therapy discontinuation.CONCLUSION When treating patients with active pulmonary tuberculosis,if an increase in lesions is observed during anti-tuberculosis treatment,it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia,timely lung biopsy is essential for early intervention.
文摘Eosinophilic esophagitis is an immune-allergic pathology of multifactorial etiology(genetic and environmental)that affects both pediatric and adult patients.Its symptoms,which include heartburn,regurgitation,and esophageal stenosis(with dysphagia being more frequent in eosinophilic esophagitis in young adults and children),are similar to those of gastroesophageal reflux disease,causing delays in diagnosis and treatment.Although endoscopic findings such as furrows,esophageal mucosa trachealization,and whitish exudates may suggest its presence,this diagnosis should be confirmed histologically based on the presence of more than 15 eosinophils per high-power field and the exclusion of other causes of eosinophilia(parasitic infections,hypereosinophilic syndrome,inflammatory bowel disease,among others)for which treatment could be initiated.Currently,the 3“D”s(“Drugs,Diet,and Dilation”)are considered the fundamental components of treatment.The first 2 components,which involve the use of proton pump inhibitors,corticosteroids,immunosuppressants and empirical diets or guided food elimination based on allergy tests,are more useful in the initial phases,whereas endoscopic dilation is reserved for esophageal strictures.Herein,the most important aspects of eosinophilic esophagitis pathophysiology will be reviewed,in addition to evidence for the various treatments.
