以间质性肺炎为首发症状的胶原血管病1例

1病例介绍患者男,51岁。因"进行性消瘦16个月,咳嗽、咳痰3个月"入院。患者16个月来无明显诱因出现体重下降28 kg,咳嗽,咳白痰。无胸痛、痰中带血及咯血;无低热、盗汗、乏力及厌食。体征:皮肤黏膜无紫绀,双肺呼吸音粗,未闻及干湿性罗音,心脏(-),双侧腹股沟淋巴结肿大。杵状指(趾)(-),神经系统(-)。既往慢性胃炎、支气管哮喘病史。两     

特发性间质性肺炎的临床病理特点

特发性间质性肺炎(IIP)是一组原因不明的肺部间质性疾病。组织病理学分类在区别不同亚类的IIP及指导IIP的治疗和判断预后方面起着重要作用。这组疾病在组织学上的诊断要点包括:炎症、纤维母细胞增殖、胶原沉积和肺组织结构重建等几方面。寻常型间质性肺炎是最常见的IIP类型,具有典型的形态学特征。IIP的其他亚型包括:非特异性间质性肺炎、脱屑性间质性肺炎、细支气管炎相关性间质性肺病和急性间质性肺炎等,这类疾病形态学表现相互重叠,并与其他弥漫性间质性肺疾病难以区别,虽然纤支镜支气管肺活检、胸腔镜肺活检是IIP病理诊断的重要依据,但在诊断时必须结合临床和影像学资料才能作出正确诊断。     

中医药治间质性肺炎缓解期1例

<正>间质性肺炎[1]是一种突发且病因不明的肺间质组织发生的弥漫性实质性肺部疾病,主要侵犯支气管壁、肺泡壁,特别是支气管周围、血管小叶间或肺泡间隔的结缔组织。其起病多有上呼吸道感染的症状,常由病毒引起,临床常表现为突然发热,干咳,可伴有胸闷气喘,出现进行性加重的呼吸困难。目前西医对于本病的治     

特发性非特异性间质性肺炎6例临床病理分析

目的探讨特发性非特异性间质性肺炎的临床病理学特征和鉴别诊断。方法对6例特发性非特异性间质性肺炎进行临床、影像学、组织病理学和免疫组化观察,并复习相关文献。结果高分辨CT显示双肺对称性毛玻璃样阴影。镜下肺组织呈均匀一致性病变,主要表现为间质慢性炎症和纤维化,肺泡间隔增宽。免疫组化示增生的肺泡上皮和支气管上皮CK、EMA（＋）。结论特发性非特异性间质性肺炎是一种重要的特异性间质性肺炎类型,应注意与寻常型间质性肺炎、淋巴细胞性间质性肺炎及过敏性肺炎等进行鉴别,对指导临床治疗和判断预后具有非常重要的意义。     

皮肌炎合并间质性肺炎1例报告

1 病例 患者，男，47岁。因关节疼痛、发热、咳嗽2月，气促15天于2001年9月26日入院。患者于2001年6月20日无明显诱因出现小关节疼，后至腕关节、肩关节，痛致握物无力，鼻根两侧出现红斑，2天后感全身疼痛，在当地行“封闭”治疗，疼痛缓解，半月后疼痛如前，出现下蹲后站起困难，给予口服中药，静滴青霉素、地塞米松5天，症状好转，停药。     

骨髓移植术后并发急性间质性肺炎的CT表现

目的探讨骨髓移植术后并发急性间质性肺炎的CT表现。方法方法分析总结60例接受骨髓移植术后出现肺部并发症患者的胸部CT资料。结果发现急性间质性肺炎15例,肺部表现主要有:(1)磨玻璃影,6例;(2)团片状影,6例;(3)小结节影,3例。结论骨髓移植术后与其它病因引起的急性间质性肺炎的胸部CT表现无明显特异性,螺旋CT是评价诊断该病的有效方法和手段。     

急性间质性肺炎1例

患者女,71岁,因干咳、呼吸困难伴发热20余日,咯血6日于2005-09-26入院.患者入院前20余日开始无明显诱因出现干咳,活动时呼吸困难,伴发热,体温最高达40℃ ,无寒战,胸痛,被当地医院诊断为"支原体肺炎",予静脉滴注"阿奇霉素、头孢曲松钠"等药物治疗10余日呼吸困难加重,发热无缓解.入院前6日开始出现咯血,为暗红色血痰,每日3～6次,每次2～3 mL,呼吸困难进行性加重,每日发热均在40℃以上,应用地塞米松、复方氨林巴比妥(安痛定)可退热.既往身体健康,无毒物、粉尘接触史,无关节疼痛及皮下结节、皮疹病史,无长期发热史,无肺部感染史及间质性肺病史,无寄生虫病史,无全身炎症反应,无药物及食物过敏史.     

特发性间质性肺炎的HRCT诊断

特发性间质性肺炎（idiopathic interstitial pneumonia，ⅡP）是一组以肺间质炎性病变为主的非肿瘤、非细菌性弥漫性问质性肺病。其共同特点为：均有一定程度的间质内细胞浸润和／或胶原沉积，且临床、影像学和病理上同其它弥漫性肺病有所不同。ⅡP病因虽不明，但与之有关的因素很多，包括病毒、支原体、免疫介导的相关疾病（如SLE、硬皮病，多发性皮肌炎等）、吸烟、先天性免疫缺陷病、获得性免疫缺陷综合征、肿瘤放射治疗、化学治疗、免疫抑制药或大剂量肾上腺皮质激素治疗等。     

骨髓移植后CMV间质性肺炎

人类巨细胞病毒（ＣＭＶ）间质性肺炎（ＩＰ）是骨髓移植常见合并症和死亡原因之一。本文就ＣＭＶ－ＩＰ的危险因素、临床表现和诊断以及防治进行了综述，着重就近年有关ＣＭＶ－ＩＰ的预防新进展进行了详细的综述。     

以黄疸为首发表现的多发性骨髓瘤一例

病例:女,56岁。皮肤黄染1周,以“急性黄疸性肝炎”收住我院传染科。患者1年前开始出现皮肤巩膜黄染,伴中上腹胀不适、纳差和乏力,无发热、腹泻,自觉尿色加深,大便无异常改变。既往史、个人史和家族史无特殊。入院体检:神志清,皮肤、巩膜重度黄染,无肝掌及蜘蛛痣;肺脏和心脏未发现异常;腹平软,无压痛及反跳痛,肝上界位于右锁骨中线第5肋间,肝脾肋下未触及,肝区叩击痛阳性,移动性浊音阴性;双下肢无凹陷性浮肿。入院后血常规:WBC6.03×109/L,中性粒细胞0.649,RBC3.55×1012/L,Hb105g/L,PLT163×109/L,网织红细胞百分比为0.01。血清ALT17…     

Acute myocardial infarction as the first sign of infective endocarditis: a case report

Infective endocarditis is a bacterial or fungal infection of the heart valves or endocardial surface, and it frequently forms vegetation and can lead to systemic embolism. Dislodged vegetation rarely results in coronary artery embolism (CAE) and subsequent acute myocardial infarction. A 43-year-old male patient was emergently brought to our hospital for suspected acute myocardial infarction. Coronary angiography was performed and it showed embolism in the left circumflex artery. Thrombus aspiration was performed during coronary angiography. Echocardiography showed formation of vegetation in the posterior leaflet of the mitral valve and multiple blood cultures showed Listeria monocytogenes. Infective endocarditis was diagnosed. Three weeks later, debridement of subacute bacterial endocarditis, mitral valve replacement, and tricuspid valvuloplasty were successfully conducted. Our findings suggest that CAE should be considered in the differential diagnosis of acute myocardial infarction. Aspiration of coronary embolus during coronary angiography followed by surgical intervention of diseased heart valves is a plausible strategy for managing CAE in infective endocarditis.     

Gastrointestinal symptoms as the first sign of chronic granulomatous disease in a neonate: A case report

BACKGROUNDChronic granulomatous disease (CGD) characterized by recurrent and severe bacterial and fungal infections is most common in childhood.CASE SUMMARYWe reported a 24-d-old male infant who developed gastrointestinal symptoms as the first sign of CGD.CONCLUSIONGastrointestinal symptoms representing the first sign of CGD are very rare, and prompt diagnosis and treatment with broad-spectrum antibiotics were of crucial importance.     

The death of Albert Prince Consort: the case against typhoid fever

The case against typhoid fever as the cause of the Prince'sdeath rests partly on some uncharacteristic clinical featuresduring the terminal 22 days of his illness, and partly on otheraspects of his temperament and emotionally threatening lifeevents, which tend to favour ulcerative colitis or Crohn's disease.That he had been intermittently unwell with abdominal symptomsfor several months before the terminal stage of his illness,only 9 days after this sensitive and vulnerable man was confrontedby an intensely personal insult, lends further support to adiagnosis of inflammatory bowel disease. His many admirablequalities unfortunately did not include those needed to surmountdeeply injured feelings at his son's behaviour, notably flexibility,sufficient sense of humour and tolerance of human frailty. Hadhe been able to swear or laugh at his son's foolishness, itmight have saved him, and so might adequate psychological management.Some patients with fulminating inflammatory bowel disease, ifthat is what the Prince had, decline such help, preferring tobrood rather than speak, and take their bottledup feelings ofresentment to the grave.