Presence Of Interstitial Pneumonitis Research Articles

The Presence of Interstitial Pneumonitis before Azacitidine-Treatment is an Unfavorable Prognostic Factor in MDS Patients

The Presence of Interstitial Pneumonitis before Azacitidine-Treatment is an Unfavorable Prognostic Factor in MDS Patients

Interstitial Pneumonitis and the Risk of Chronic Allograft Rejection in Lung Transplant Recipients

The presence of interstitial pneumonitis (IP) on surveillance lung biopsy specimens in lung transplant recipients is poorly described, and its impact on posttransplant outcomes is not established. The following study assessed the association of posttransplant IP with the development of bronchiolitis obliterans syndrome (BOS). We examined all recipients of primary cadaveric lung transplants at our institution between January 1, 2000, and December 31, 2007 (N = 145). Patients had bronchoscopies with BAL, and transbronchial biopsies performed for surveillance during posttransplant months 1, 3, 6, and 12 as well as when clinically indicated. Patients were given a diagnosis of IP if, in the absence of active infection and organizing pneumonia, they showed evidence of interstitial inflammation and fibrosis on two or more biopsy specimens. IP was a significant predictor of BOS (OR, 7.84; 95% CI, 2.84-21.67; P < .0001) and was significantly associated with time to development of BOS (hazard ratio, 3.8; 95% CI, 1.93-7.39; P = .0001) within the first 6 years posttransplant. The presence of IP did not correlate with a significantly higher risk of mortality or time to death. There was no association between the presence of IP and the development of or time to acute rejection. The presence of IP on lung transplant biopsy specimens suggests an increased risk for BOS, which is independent of the presence of acute cellular rejection.

Outcomes of Hematopoietic Stem Cell Transplantation in Primary Immunodeficiency: A Report from the Australian and New Zealand Children’s Haematology Oncology Group and the Australasian Bone Marrow Transplant Recipient Registry

We performed a retrospective analysis on the outcomes of 135 hematopoietic stem cell transplantations (HSCTs) for primary immunodeficiency disorders in Australian and New Zealand Children’s Haematology Oncology Group transplantation centers between 1992 and 2008. The most common indications for HSCT were severe combined immunodeficiency, Wiskott-Aldrich syndrome, and chronic granulomatous disease. Five-year overall survival (OS) was 72% for the entire cohort. Disease-specific 5-year OS was 70% for severe combined immunodeficiency, 81% for Wiskott-Aldrich syndrome, and 69% for chronic granulomatous disease. Transplantation-related mortality (TRM) was 10% at day +100. TRM and OS were equivalent in recipients of related and unrelated donor transplants. Source of stem cells had no impact on TRM or OS with outcomes following unrelated umbilical cord blood similar to unrelated bone marrow. The presence of interstitial pneumonitis, active cytomegalovirus infection, or veno-occlusive disease were all independent variables that significantly decreased OS. This large series supports the use of HSCT as curative therapy for a range of primary immunodeficiency disorders, demonstrating excellent survival after both related and unrelated donor transplantation.

Surfactant protein-D is more useful than Krebs von den Lungen 6 as a marker for the early diagnosis of interstitial pneumonitis during pegylated interferon treatment for chronic hepatitis C.

To examine the usefulness of serum Krebs von den Lungen 6 (KL-6) and surfactant protein-D (SP-D) as markers of interstitial pneumonitis. Many antiviral therapies have become available for chronic hepatitis C, including pegylated interferon (PEGIFN) plus ribavirin. Since interstitial pneumonitis is a serious adverse drug reaction during interferon therapy, interferon treatment requires caution in respiratory disease patients. Hence, the predictors of interstitial pneumonitis have not been elucidated. Fifty-two chronic hepatitis C patients who received PEG-IFN plus ribavirin were studied; 14 patients received PEGIFN-α 2a, and 38 received PEG-IFN-α 2b. Serum KL-6 and SP-D levels were measured during treatment. Time changes in serum KL-6 and SP-D levels, as well as the presence of interstitial pneumonitis, were investigated. No cases of pneumonitis in which both markers were below the standard values were seen. Interstitial pneumonitis developed in 1 of the 5 patients in whom both markers were above standard values. Patients whose KL-6 levels alone exceeded the standard value had bacterial pneumonia and emphysema, not interstitial pneumonitis. Though no correlation between SP-D and KL-6 levels was observed, KL-6 levels tended to increase after interstitial pneumonitis was detected on imaging, but SP-D levels increased before imaging detection. It is important to monitor changes in levels of serum markers and other factors to avoid interstitial pneumonitis during PEG-IFN therapy. SP-D in particular may be important for early detection of interstitial pneumonitis.

INTERSTITIAL PNEUMONITIS FOLLOWING LUNG TRANSPLANTATION: A POTENTIAL PREDICTOR OF BRONCHIOLITIS OBLITERANS SYNDROME

PURPOSE: We hypothesized that the presence of interstitial pneumonitis (IP) on bronchoscopic lung biopsy is associated with an increased future risk of bronchiolitis obliterans syndrome (BOS) and death in lung transplant recipients.

Administración de vacunas y casos de muerte súbita del lactante en el Perú, 2001. ¿Asociación o coincidencia temporal?

Objectives: To describe clinical, socio-economic, and pathological characteristics of nine infants who died hours after receiving anti-polio and DPT vaccines, together with anti-Haemophilus influenzae b or in association to anti-hepatitis B vaccine or BCG. Materials and methods: Review of the clinical record, interview with the healthcare team in charge of immunization, and with parents of the deceased infant. Review the autopsy and pathology reports, as well as an interview with pathologists and forensic physicians. Quality control assessment of vaccines used immunohistochemistry examinations for virus diagnosis. Results: Between August and December 2001, nine cases of infant death were reported in Peru, between 8 hours and 3 days after receiving DPT and anti-polio vaccines. After immunization, symptoms appeared from thirty minutes to three hours, and death occurred between 8 to 78 hours. Most frequently reported symptoms were: irritability (8/9), persistent weeping (6/9), somnolence (5/9), nose and mouth bleeding (5/9). All cases occurred in poor or very poor families. Quality control assessments corroborated that vaccines complied with standards set by the World Health Organization. Causes of death reported in autopsies were pneumonia in 2 cases and pulmonary edema in 5 cases; pathology reports indicated the presence of interstitial pneumonitis and lymphocyte meningitis. No viral cytopathic effects in pulmonary tissues were found, and toxicological studies were reported as negative. Conclusions: There is no evidence of a causal relationship between fatal events and vaccine administration.