CHRONIC EOSINOPHILIC PNEUMONIA IN A PATIENT WITH ATAXIA TELANGIECTASIA

Abstract The first reported case of chronic eosinophilic pneumonia in a patient with ataxia telangiectasia is described. The patient displayed the immunoglobulin deficiencies and abnormalities of lymphocyte numbers characteristic of ataxia telangiectasia. Treatment with corticosteroids led to a dramatic recovery. The proposed pathogenetic mechanisms of chronic eosinophilic pneumonia are discussed in the light of the immunological abnormalities associated with ataxia telangiectasia.     

INTERFERON-INDUCED ANOSMIA IN A PATIENT WITH CHRONIC HEPATITIS C

We report a patient with chronic active hepatitis C developing acute anosmia during interferon (IFN) therapy, On July 31, he began receiving 6 MU of IFN-α daily. On September 26, he failed to smell gas leaking from a gas cooker, so IFN therapy was discontinued. He showed no reaction on a standard olfactory acuity test. As the patient had borderline diabetes, the association of anosmia with impaired glucose tolerance cannot completely be excluded, but his anosmia was probably induced by IFN therapy, since anosmia developed 10 days after the initiation of the IFN therapy, without any deterioration of his glucose intolerance.     

吡喹酮治疗慢性血吸虫病引起过敏性紫癜1例

1 临床资料 患者,女,54岁,农民,安徽省桐城市双港镇白果乡(血吸虫病非疫区)人.2004年5月10日在血吸虫病普查中因血清免疫学阳性(IHA 1∶10,粪便水洗沉淀镜检未发现血吸虫卵)而入院接受治疗.询检:患者幼年生活在血吸虫病疫区,1970年代初期离开疫区而生活于非疫区,无血吸虫病治疗史,无不良嗜好,无过敏史,无吡喹酮治疗禁忌症,服药前患者一般情况良好,体检未发现异常.按吡喹酮40 mg/kg、总剂量2 400 mg 2日疗法,进行血吸虫病原治疗.     

EPSTEIN-BARR VIRUS-ASSOCIATED HAEMOPHAGOCYTIC SYNDROME IN A PATIENT WITH JUVENILE CHRONIC ARTHRITIS

We describe a case of reactive haemophagocytic syndrome (RHS)in a patient with previous polyarticular juvenile chronic arthritis(JCA). This is the first reported association of these conditionsand may be indicative of defective immunological responses toviral infections in this form of JCA. KEY WORDS: Epstein–Barr virus, Haemophagocytic syndrome, Juvenile chronic arthritis, Acquired coagulation disorder, Interferon-     

INFLAMMATORY PSEUDOTUMOR OF THE LIVER IN A PATIENT WITH CHRONIC SCLEROSING CHOLANGITIS

Inflammatory pseudotumor of the liver (IPL) is a rare fibro-inflammatory mass of unknown etiology, resembling a neoplasm. We report the occurrence of such a lesion in a young male Cambodian refugee to Canada who had a history of chronic cholangitis. Imaging studies suggested an intrahepatic abscess. Our report suggests that the lesion in this patient may have resulted from chronic portal pyemia.     

CYTOMEGALOVIRUS COLITIS MIMICKING COLON CARCINOMA IN AN HIV-NEGATIVE PATIENT WITH CHRONIC RENAL FAILURE

Cytomegalovirus (CMV) colitis is thought to occur almost exclusively in immunosuppressed persons. Colonoscopy in patients with CMV colitis usually shows diffuse or localized ulceration, although mucosal friability, erosions, hemorrhage, and plaque-like pseudomembranes may be observed. We report on a patient with chronic renal failure undergoing hemodialysis therapy who had abdominal symptoms, including bloody diarrhea, along with colonoscopic findings suggestive of carcinoma of the colon. The patient was not infected with the human immunodeficiency virus and had normal lymphocyte subset numbers. He was subsequently found to have invasive CMV disease of the colon. CMV colitis can occur in persons who are not severely immunosuppressed, and its colonoscopic appearance may mimic that of colon cancer.     

ENDOSCOPIC TREATMENT FOR THE BENIGN BILIARY STRICTURE IN THE PATIENT WITH CHRONIC PANCREATITIS

In some patients with chronic pancreatitis (CP), strictures are observed in the intrapancreatic bile ducts due to fibrosis and inflammation in the pancreas. Normally, even when biliary strictures exist, obstructive jaundice is rarely observed. It seemed that obstructive jaundice was brought about by temporary pancreatitis due to immoderate alcohol ingestion, followed by the aggravation of the intrapancreatic biliary stricture. When immoderate alcohol ingestion is incriminated for the pancreatic disorder, the patient should be strictly instructed to abstain from alcohol, but failure to observe this instruction seems to render endoscopic biliary stenting ineffective. When CP is complicated with pancreatolithiasis, stone fragmentation using extracorporeal shock wave lithotripsy (ESWL) is effective, and combination with endoscopic lithotomy makes it possible to remove pancreatic stones in the main pancreatic duct (MPD). To treat the beside dilating stricture of the MPD, balloon dilation and pancreatic duct stenting are performed. We obtained good results with 10 Fr pancreatic duct stents, but biliary strictures are better treated with a combination of these methods. When 10 Fr or larger straight biliary stents are used, they may be dislodged or stray if the bile duct is sharply curved. To prevent this accident we have used 10 Fr double layer stents and obtained good results. In patients with benign biliary strictures, stents are temporarily placed and should be removable. Some cases have been reported where Wallstent gave good results in a short period, but the stents were occluded due to hyperplastic proliferation of the biliary epithelium. Metal stents are not considered desirable for benign biliary strictures. Our results seem to support the assumption that benign biliary strictures are improved with 10 Fr or larger biliary stents while exercizing care to keep the patient abstinent from alcohol and performing ESWL and endoscopic treatment for CP.     

吡喹酮治疗慢性血吸虫病合并心房颤动1例

患者,女性,57岁,农民,居住血吸虫病流行区,自觉心悸、头晕,胸闷数年,最近解浓血便,查IHA 1:10阳性,而收住院.     

66例甲状腺功能亢进症患者骨质改变的临床分析

本文对66例甲亢患者测定了桡、尺骨矿物质含量(BMC)、骨密度(BD)、甲状旁腺激素(PTH)以及各种钙磷代谢的指标。50％的患者BMC和BD水平降低,44％的患者PTH水平升高。BMC和BD与病程、甲状腺肿、突眼及应用甲状腺素治疗呈相关关系。我们的初步结果表明BMC和BD的测定是甲亢骨病的一个辅助诊断指标。