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Tracheobronchial lesions in eosinophilic pneumonia.
[allergic bronchopulmonary aspergillosis]
Eosinophilic
pneumonia
(
EP
)
is
characterized
by
eosinophil
infiltration
in
the
lung
parenchyma
.
However
,
tracheobronchial
lesions
associated
with
the
disease
have
been
poorly
described
.
To
clarify
the
frequency
and
characteristics
of
cases
with
tracheobronchial
lesions
in
EP
,
we
performed
a
retrospective
review
of
EP
patients
.
We
included
36
EP
cases
seen
from
January
2004
to
December
2007
at
the
Kinki-
Chuo
Chest
Medical
Center
.
The
incidence
of
tracheobronchial
nodules
and
associated
clinical
features
were
analyzed
.
Of
these
36
patients
,
29
had
chronic
eosinophilic
pneumonia
(
CEP
)
;
1
,
acute
EP
;
3
,
drug-induced
EP
;
2
,
allergic
bronchopulmonary
aspergillosis
;
and
1
,
parasite-related
EP
.
Only
2
of
the
29
CEP
cases
had
tracheobronchial
lesions
.
For
both
of
these
cases
,
bronchoscopy
revealed
multiple
whitish
nodules
on
the
tracheobronchial
mucosa
.
The
associated
histopathological
findings
revealed
squamous
metaplasia
and
eosinophil
infiltration
in
the
subepithelial
region
.
In
both
cases
,
the
nodules
disappeared
after
steroid
therapy
.
The
prevalence
of
tracheobronchial
lesions
was
6
.
9
%
in
CEP
patients
and
5
.
6
%
in
EP
patients
overall
.
EP
patients
were
divided
into
3
groups
:
CEP
with
nodules
(
n
=
2
)
,
CEP
without
nodules
(
n
=
27
)
,
and
other
EP
(
n
=
7
)
.
We
found
that
the
CEP
with
nodules
group
showed
a
relatively
higher
incidence
of
respiratory
symptoms
,
higher
white
blood
cell
(
WBC
)
count
,
and
higher
levels
of
peripheral
and
bronchoalveolar
eosinophilia
than
the
other
groups
.
Tracheobronchial
nodules
represent
rare
observations
within
the
EP
population
,
which
are
likely
to
reflect
a
severe
disease
condition
.
Diseases
Validation
Diseases presenting
"pneumonia"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
allergic bronchopulmonary aspergillosis
alpha-thalassemia
classical phenylketonuria
cohen syndrome
congenital diaphragmatic hernia
heparin-induced thrombocytopenia
hydrocephalus with stenosis of the aqueduct of sylvius
junctional epidermolysis bullosa
lamellar ichthyosis
legionellosis
liposarcoma
lymphangioleiomyomatosis
monosomy 21
oculocutaneous albinism
omenn syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
scrub typhus
severe combined immunodeficiency
triple a syndrome
waldenström macroglobulinemia
wiskott-aldrich syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated