Advances in respiratory medicine
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Idiopathic pulmonary fibrosis (IPF) and hypersensitivity pneumonitis (HP) belong to heterogenic group of interstitial lung diseases (ILD). For the reason that this group of diseases present with complex clinical non-specific features, they represent a diagnostic and therapeutic challenge. ⋯ Moreover, this review summarizes the role of selected signaling pathways and some miRNAs which are their regulators during development and progression of IPF and HP. Recent advances indicate the potential role of miRNAs as a molecular markers differentiating clinical course of ILD.
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Pulmonary Langerhans' cell histiocytosis (PLCH) is a rare disorder of unknown cause characterised by the infiltration of the lungs and other organs by the bone marrow derived Langerhans' cells, which carry mutations of BRAF gene and/or NRAS, KRAS and MAP2K1 genes. It occurs predominantly in young smokers, without gender predominance. The disease is characterised by formation of eosinophilic granulomas with the presence of Langerhans' cells infiltrating and destroying distal airways. ⋯ There are no evidence based data regarding systemic steroid therapy. The treatment of progressive PLCH is based on cladribine or cytarabine as salvage therapy. The prognosis is good, and over 85% of patients survive 10 years.
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Review Case Reports
Spontaneous resolution of nitrofurantoin-induced chronic pulmonary toxicity presenting with respiratory failure.
Nitrofurantoin is one of the most common drugs implicated in drug-induced pulmonary toxicities, the manifestations of which range from dose-independent acute self-limiting reactions to chronic dose-dependent pathologies. The severity of these pulmonary adverse effects may range from trivial hypersensitivity reactions to extensive and irreversible lung fibrosis leading to respiratory failure and death. Symptomatic and supportive treatment in addition to discontinuation of the drug usually suffices for the management of mild reactions. ⋯ Corticosteroids, inhalational or systemic, were not used. Spontaneous normalization of clinico-radiological features in nitrofurantoin induced chronic lung disease presenting with respiratory failure has rarely been reported previously. The related literature is also reviewed.