Sarcoidosis Vasc Dif
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Sarcoidosis Vasc Dif · Oct 2011
Interferon gamma release assay (QuantiFERON-TB Gold In Tube) in patients of sarcoidosis from a population with high prevalence of tuberculosis infection.
Detecting latent tubercular infection (LTBI) in sarcoidosis has important treatment implications. Traditionally tuberculin skin test (TST) is relied upon for this purpose. However, sarcoidosis is known to produce tuberculin anergy, which is not affected by high prevalence of tuberculosis (TB) infection. Interferon gamma release assays (IGRAs) have a higher sensitivity and specificity for detecting Mycobacterium tuberculosis (MTB) infection than the conventional TST as they utilize antigens specific for MTB complex. However, there is limited data regarding the performance of these tests in sarcoidosis, particularly in a setting of high population prevalence of LTBI. Herein, we studied the utility of IGRAs in the diagnostic work up of patients with sarcoidosis. ⋯ There is anergy to tuberculin in sarcoidosis. However, the results of QFT are not similarly affected. QFT continues to remain positive in many patients with sarcoidosis, and thus may be more accurate to detect LTBI in these patients.
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Sarcoidosis Vasc Dif · Oct 2011
Prognostic factors for idiopathic pulmonary fibrosis: clinical, physiologic, pathologic, and molecular aspects.
Previous studies identified clinical and physiologic factors of idiopathic pulmonary fibrosis (IPF) that are related to an increased risk of mortality. But there are few studies about histologic and molecular approach. ⋯ This study confirmed the amount of smoking, abrupt decrease in follow-up pulmonary function parameters, fibroblastic foci, and increased levels of CRP concentration at diagnosis were significantly associated with poor survival. Larger studies are required to confirm all prognostic factors including CRP.
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Sarcoidosis Vasc Dif · Oct 2011
Polymyxin-B hemoperfusion for acute exacerbation of idiopathic pulmonary fibrosis: serum IL-7 as a prognostic marker.
Acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) has an extremely poor prognosis. Direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) has been used to improve oxygenation for acute respiratory distress syndrome. The study aim was to retrospectively determine the predictive factors affecting the prognosis of AE of IPF treated with PMX-DHP. ⋯ The results suggest that serum IL-7 may be a useful prognostic factor for patients with AE of IPF treated with PMX-DHP, possibly reflecting underlying anti-fibrotic mechanisms.
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Sarcoidosis Vasc Dif · Oct 2011
Optimal scoring of serial change on chest radiography in sarcoidosis.
The optimal means of quantifying change on chest radiography in sarcoidosis is uncertain. In current guidelines, the role of serial measurement of carbon-monoxide diffusing capacity (DLco) remains undefined and the prevalence of discordance between serial chest radiographic change and pulmonary function tends is unknown. ⋯ Change in radiographic extent is more applicable to routine monitoring in sarcoidosis than change in radiographic stage. In future guidelines, the role of serial gas transfer estimation and reconciliation of divergent chest radiographic and functional trends might usefully be addressed.
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Sarcoidosis Vasc Dif · Oct 2011
Case ReportsSuccessful pregnancy complicated by persistent pneumothorax in a patient with lymphangioleiomyomatosis (LAM) on sirolimus.
We report a successful pregnancy in a patient with longstanding LAM on treatment with sirolimus. During temporary discontinuation fo sirolimus in early pregnancy, lung function declined but recovered after resumption of sirolimus. Pregnancy was complicated by a persistent pneumothorax which was treated surgically postnatally. The child has had a normal development despite exposure to low dose sirolimus intermittently during early embryonal and mid-fetal life.