fibrin and Dyspnea

Pulmonary vascular inflammatory disorders may involve all components of the pulmonary vasculature, including capillaries. The principal histopathologic features of pulmonary capillaritis include capillary wall necrosis with infiltration by neutrophils, interstitial erythrocytes, and/or hemosiderin, and interalveolar septal capillary occlusion by fibrin thrombi. Immune complex deposition is variably present. Patients often present clinically with diffuse alveolar hemorrhage, which is characterized by dyspnea and hemoptysis; diffuse, bilateral, alveolar infiltrates on chest radiograph; and anemia. Pulmonary capillaritis has been reported with variable frequency and severity as a manifestation of Wegener's granulomatosis, microscopic polyarteritis, systemic lupus erythematosus, Goodpasture's syndrome, idiopathic pulmonary renal syndrome, Behçet's syndrome, Henoch-Schönlein purpura, IgA nephropathy, antiphospholipid syndrome, progressive systemic sclerosis, and diphenylhydantoin use. In addition to history, physical examination, and routine laboratory studies, certain ancillary laboratory tests, such as antineutrophil cytoplasmic antibodies, antinuclear antibodies, and antiglomerular basement membrane antibodies, may help diagnose an underlying disease. Diagnosis of pulmonary capillaritis can be made by fiberoptic bronchoscopy with transbronchial biopsy, but thoracoscopic biopsy is often employed. Since many disorders can result in pulmonary capillaritis with diffuse alveolar hemorrhage, it is crucial for clinicians and pathologists to work together when attempting to identify an underlying disease. Therapy depends on the disorder that gave rise to the pulmonary capillaritis and usually includes corticosteroids and cyclophosphamide or azathioprine. Since most diseases that result in pulmonary capillaritis are treated with immunosuppression, infection must be excluded aggressively.

Topics: Anemia; Bronchoscopy; Capillaries; Diagnosis, Differential; Dyspnea; Erythrocytes; Fibrin; Hemoptysis; Hemorrhage; Hemosiderin; Humans; Immunosuppressive Agents; Lung; Lung Diseases; Necrosis; Neutrophils; Pulmonary Alveoli; Pulmonary Embolism; Thoracoscopy; Vasculitis

Topics: Absorption; Amylases; Antineoplastic Agents; Breast Neoplasms; Bronchial Neoplasms; Capillary Permeability; Carcinoembryonic Antigen; Catheterization; Drainage; Dyspnea; Fibrin; Filtration; Humans; Hydrogen-Ion Concentration; Lymphoma; Pain; Pancreatic Neoplasms; Pleural Effusion; Pleural Neoplasms; Pregnancy Proteins; Quinacrine; Talc; Tetracyclines; Tissue Adhesives; Ultrasonography

Topics: Adenosine Diphosphate; Blood Platelets; Coronary Vessels; Dyspnea; Fibrin; Histamine; Humans; Hypertension; Hypoxia; Platelet Factor 4; Prostaglandins; Pulmonary Embolism; Serotonin

Topics: Airway Obstruction; Angiography; Animals; Anticoagulants; Dyspnea; Electrocardiography; Fibrin; Fibrinogen; Fibrinolytic Agents; Heart Auscultation; Heparin; Humans; Ligation; Pulmonary Artery; Pulmonary Embolism; Radionuclide Imaging; Thrombophlebitis; Vena Cava, Inferior

Topics: Biopsy; Bronchi; Bronchial Diseases; Bronchitis; Bronchoscopy; Chyle; Cough; Dyspnea; Fibrin; Frozen Sections; Humans; Lymphocytes; Lymphography; Male; Middle Aged; Mucus; Oxygen; Triglycerides

Topics: Adult; Animals; Cattle; Dermatitis, Contact; Dyspnea; Female; Fibrin; Humans; Tooth Extraction; Urticaria

A 69-year-old woman was admitted because of dyspnea. Thereafter, she fell into a state of shock. Resuscitation was attempted but she did not respond to it and died on the second hospital day. According to the autopsy findings, a wide range of area from the larynx to the trachea was covered with pseudomembrane. In the culture of bacteria, alpha Streptococcus and Corynebacterium genus (non-diphtherial) were all that was detected. These findings suggest that pseudomembranous lesion, an endogenous foreign matter of the air passage should be suspected when a patient presents with sudden dyspnea.

Topics: Aged; Airway Obstruction; Autopsy; Bronchitis; Corynebacterium; Death, Sudden; Dyspnea; Female; Fibrin; Humans; Neutrophils; Streptococcus pyogenes

Three cases of life-endangering airway obstruction by fibrin membranes are reviewed which developed in a 17-year-old girl with virus pneumonia, in a 21-year-old girl with a history of thrombopathy after general anaesthesia with naso-tracheal intubation and in a 23-year-old woman after short anaesthesia with orotracheal intubation. Possible causal factors, the clinical symptoms and the therapeutic measures taken by the anaesthetist are discussed. Since these cases are generally in a state of severe respiratory collapse by the time treatment is initiated general anaesthesia with muscle relaxation should be attempted only if the anaesthesist is certain that he can effectively ventilate the patient before and during the operation. Otherwise it is better to apply assisted ventilation with oxygen and halothane via a mask until a clear air passage has been restored. Administration of anticholine drugs and control of shock are essential.

Topics: Adolescent; Adult; Airway Obstruction; Dyspnea; Female; Fibrin; Humans; Intubation, Intratracheal; Pneumonia, Viral; Succinylcholine; Tracheitis; Tracheotomy; Tubocurarine

Topics: Age Factors; Bronchitis; Bronchoscopy; Child, Preschool; Dyspnea; Fibrin; Humans; Infant

Topics: Administration, Oral; Animals; Constriction; Dyspnea; Female; Fibrin; Growth; Heart Ventricles; Hemorrhage; Hypertrophy; Inclusion Bodies; Injections, Intraperitoneal; Iron; Liver; Lung; Lymphocytes; Mast Cells; Muscle, Smooth; Organ Size; Pulmonary Artery; Pulmonary Edema; Pulmonary Veins; Pyrrolizidine Alkaloids; Rats; Time Factors

Topics: Anti-Bacterial Agents; Blood Coagulation; Blood Sedimentation; Bronchitis; Bronchography; Child, Preschool; Cough; Dyspnea; Exudates and Transudates; Female; Fibrin; Humans; Infant; Male; Pulmonary Atelectasis