Nihon Kyōbu Shikkan Gakkai zasshi
-
Nihon Kyobu Shikkan Gakkai Zasshi · Oct 1993
Case Reports[A case of eosinophilic pneumonia due to tolfenamic acid].
We report a case of pneumonitis induced by tolfenamic acid. A 23-year-old woman was admitted to our hospital because of cough and fever. She had been treated with tolfenamic acid and other medications for lumbago. ⋯ The lymphocyte stimulation test (LST) and challenge test for tolfenamic acid were positive. Based on these findings, we diagnosed this case as pneumonitis (eosinophilic pneumonia) due to tolfenamic acid. To our knowledge, there has been no reported case of pneumonitis due to this drug in Japan.
-
Nihon Kyobu Shikkan Gakkai Zasshi · Oct 1993
Case Reports[A case of hypersensitivity pneumonitis induced by toluene diisocyanate presenting with transient bronchoconstriction].
A 50-year-old male spray paint worker was admitted with non-productive cough and dyspnea on exertion. Chest X-ray and chest CT showed diffuse interstitial shadows in the bilateral lung fields. After admission, the symptoms and chest X-ray findings improved over several days, and he was followed as an outpatient. ⋯ Paint contains toluene diisocyanate, and challenge test to toluene diisocyanate was positive. In the early course, this case presented with bronchoconstriction; bronchial reversibility and bronchial hyperresponsiveness to methacholine were positive. Bronchoconstriction may cause worsening of respiratory symptoms in patients with hypersensitivity pneumonitis induced by isocyanates.
-
Nihon Kyobu Shikkan Gakkai Zasshi · Sep 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Effects of aerosol oxitropium bromide and fenoterol on maximal exercise capacity in chronic obstructive pulmonary disease and their correlation with air flow during exercise and with parameters of maximal exercise].
To examine the effects of bronchodilators on maximal exercise capacity and their correlation with airflow during exercise in patients with chronic obstructive pulmonary disease (COPD), we conducted a double-blind, randomized comparison between inhaled fenoterol (beta 2-agonist) and oxitropium bromide (anticholinergic agent) in 8 patients with stable COPD (mean age 73 years, mean FEV1 1.1 L, mean FEV1% 50%). Only oxitropium bromide resulted in statistically significant improvement in FEV1 40 min after inhalation. On maximal exercise, fenoterol did not affect oxygen uptake (VO2 max), minute ventilation (VEmax), respiratory frequency (Rfmax), ventilatory efficacy (VEmax/VO2 max), peak expiratory flow during exercise (PEFmax), heart rate (HRmax) and dyspnea (Borg Scale Slope). ⋯ There was no correlation between changes in dyspnea during exercise and changes in FEV1 and PEFmax after oxitropium bromide inhalation. We conclude that inhaled oxitropium bromide, an anticholinergic agent, reduces dyspnea during exercise in patients with COPD. This favorable effect was not due to change of airflow limitation during exercise, and other factors can thus influence reduction of dyspnea during exercise in these patients.
-
Nihon Kyobu Shikkan Gakkai Zasshi · Sep 1993
Case Reports[A case of bronchogenic squamous cell carcinoma associated with Swyer-James syndrome].
Swyer-James syndrome is considered to be a relatively uncommon disease entity presenting with unilateral hyperlucent lung due to hypoplasia of a pulmonary artery and bronchiectasis of the affected lung. Association of bronchogenic carcinoma with Swyer-James syndrome has not apparently been reported in any previous literature, except for one Japanese case. In the present paper, we describe a 48-year-old male individual, who developed poorly differentiated squamous cell carcinoma of the right upper lobe bronchus after he had been diagnosed to have Swyer-James syndrome with unilateral hyperradiancy of the left lung. It is suggested that the bronchial epithelium of the unaffected lung in Swyer-James syndrome is likely to be more exposed to extrinsic carcinogens than that of the affected, underventilated lung, hence resulting in a higher risk of developing bronchogenic carcinoma.
-
Nihon Kyobu Shikkan Gakkai Zasshi · Sep 1993
Case Reports[A case of sho-saiko-to-induced pneumonitis, diagnosed by lymphocyte stimulation test using bronchoalveolar lavage fluid].
A 66-year-old Japanese man was admitted to our hospital with fever, cough and dyspnea. He had been taking Sho-Saiko-to, a traditional Chinese medicine, for twenty days. On admission, chest X-ray examination revealed a reticular pattern in the bilateral lungs, and respiratory failure was evident. ⋯ The diagnosis of Sho-Saiko-to-induced pneumonitis was made from the clinical course, laboratory findings, BALF cell analysis, pathological findings and LST using BALF. Only 13 cases of pneumonitis due to administration of traditional Chinese medical drugs have been reported. This case suggests that LST using BALF is useful for the diagnosis of drug-induced pneumonitis.