Mesalamine-induced eosinophilic pleural effusion

2020 ◽  
Vol 13 (4) ◽  
pp. e233886 ◽  
Author(s):  
Abdullah Al-abcha ◽  
Fazal Raziq ◽  
Shouq Kherallah ◽  
Ahmad Alratroot
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Symptomatic Improvement ◽  
X Ray ◽  
Fluid Analysis ◽  
Ct Angiogram ◽  
History Of ◽  
Chest X Ray ◽  
Eosinophilic Pleural Effusion

A 45-year-old woman with a medical history of ulcerative colitis (UC) presented with difficulty in breathing. The patient was diagnosed with UC a month prior to presentation and was started on mesalamine suppository. Chest x-ray (CXR) on presentation showed bilateral pleural effusion, which was confirmed on CT angiogram of the chest. Diagnostic and therapeutic thoracentesis was performed and 0.7 L of pleural fluid was removed from the left side. The pleural fluid analysis was consistent with exudative pleural effusion with eosinophilia. Symptomatic improvement was noted after thoracentesis. Mesalamine was stopped and repeat CXR was obtained on the follow-up visit, which showed no pleural effusion. The Naranjo score was calculated to be 7, indicating that the eosinophilic pleural effusion was most probably secondary to adverse reaction from mesalamine.

scholarly journals Chylothorax: complication attributed to dasatinib use

2019 ◽  
Vol 12 (12) ◽  
pp. e231653 ◽  
Author(s):  
Abdullah Al-abcha ◽  
Mian Harris Iftikhar ◽  
Fawzi Abu Rous ◽  
Heather Laird-Fick
Keyword(s):  
Ejection Fraction ◽  
Pleural Fluid ◽  
Systolic Pressure ◽  
Symptomatic Improvement ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Ventricular Systolic Pressure ◽  
Fluid Analysis ◽  
Ct Angiogram ◽  
History Of

A 63-year-old woman with a medical history of chronic myelogenous leukaemia treated with dasatinib, chronic obstructive pulmonary disease and heart failure with preserved ejection fraction presented with difficulty in breathing. Chest X-ray showed large right-sided pleural effusion, which was confirmed on a CT angiogram of the chest. Echocardiogram showed an ejection fraction of 61% with moderate to severely dilated right ventricle and right ventricular systolic pressure of 60 mm Hg. Diagnostic and therapeutic thoracentesis was performed, and 2.2 L of pleural fluid was removed. Pleural fluid analysis was consistent with chylothorax. Significant symptomatic improvement was noted after thoracentesis. In the absence of an alternate explanation, chylothorax was attributed to dasatinib, which was switched to nilotinib. This resulted in resolution of her pleural effusions.

scholarly journals Study of etiology of pleural effusion in Telangana population

2019 ◽  
Vol 6 (6) ◽  
pp. 1798
Author(s):  
Mohd Ifthekhar Mohiuddin ◽  
Parth N. Patel
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Clinical Manifestations ◽  
Pragmatic Approach ◽  
Gold Standard Method ◽  
X Ray ◽  
Fluid Analysis ◽  
Chest X Ray ◽  
Pedal Edema

Background: Among 86 patients aged between 18 to 65 of both sexes having pleural effusion due to various clinical etiologies were studied.Methods: Chest x-ray PA. was studied, 20 ml of pleural fluid was aspirated to study bio-chemically, microbiologically and pathological. Echo-cardiography, USG abdomen and biopsy of pleura was also done in same patients in whom diagnosis or etiology was unclear.Results: Among 59(68.6%) had fever, 68(79%) had cough, 40(46.5%) had breathlessness, 20(23.2%) had pedal edema, 42(48.8%) had chest pain, 5(5.8%) had abdominal distention. 52(60.4%) had tubercular pleural effusion 34(39.5%) had non- tubercular pleural types of non-tubercular PE effusion (PE) included 8(23.5%) synpneumonic, 5(14.7%) had CCF, 11(32.3%) had malignancy, 2(5.88%) had RA, 2(5.88%) had dengue fever, 2(5.88%) had pancreatitis, 4(11.7%) had Hypoproteinaemia.Conclusions: This pragmatic approach to pleural effusion for patients with different clinical manifestations as pleural fluid analysis is gold standard method in evaluation pleural effusion of different etiology. Background: Among 86 patients aged between 18 to 65 of both sexes having pleural effusion due to various clinical etiologies were studied.Methods: Chest x-ray PA. was studied, 20 ml of pleural fluid was aspirated to study bio-chemically, microbiologically and pathological. Echo-cardiography, USG abdomen and biopsy of pleura was also done in same patients in whom diagnosis or etiology was unclear.Results: Among 59(68.6%) had fever, 68(79%) had cough, 40(46.5%) had breathlessness, 20(23.2%) had pedal edema, 42(48.8%) had chest pain, 5(5.8%) had abdominal distention. 52(60.4%) had tubercular pleural effusion 34(39.5%) had non- tubercular pleural types of non-tubercular PE effusion (PE) included 8(23.5%) synpneumonic, 5(14.7%) had CCF, 11(32.3%) had malignancy, 2(5.88%) had RA, 2(5.88%) had dengue fever, 2(5.88%) had pancreatitis, 4(11.7%) had Hypoproteinaemia.Conclusions: This pragmatic approach to pleural effusion for patients with different clinical manifestations as pleural fluid analysis is gold standard method in evaluation pleural effusion of different etiology.

scholarly journals Characteristics of Patients with Tuberculous Pleural Effusion in Rural Nepal

2013 ◽  
Vol 1 (1) ◽  
pp. 31
Author(s):  
M S Paudel ◽  
Anjana Kafle ◽  
Bishal Khatri Chhetri ◽  
Sahadev Prasad Dhungana ◽  
Anuj Poudel ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Complete Blood Count ◽  
Protein Ratio ◽  
Mortality And Morbidity ◽  
Tuberculous Pleural Effusion ◽  
X Ray ◽  
Fluid Analysis ◽  
Chest X Ray ◽  
Rural Nepal

  Introduction: Tuberculosis (TB) is a major cause of mortality and morbidity in developing countries. TubercularPleural effusion is the second most common form of extra pulmonary tuberculosis (EPTB), superseded in Prevalence only by lymph node tuberculosis. Pleural effusion occurs in approximately 5% of patients with TB. The purpose of this study was to assess the demographic characteristics of patients presenting with pleural effusion in rural Nepal.   Methods: A retrospective study was conducted with all the cases diagnosed and admitted with pleural effusion at Lumbini Medical College And Teaching Hospital from April 2011 to March 2013 of all the cases diagnosed andadmitted with pleural effusion were included in the study. Hundred cases diagnosed with pleural effusion by clinical Examination or chest X-ray or ultrasonography’s (USG) of the chest were included in the studied. The following parameters patients demographic profile, causes of pleural effusion, location (unilateral/bilateral), hemoglobin and complete blood count, sputum stain and culture sensitivity, Monteux test, chest X-ray and USG findings and Pleural fluid analysis (biochemical, hematological, microbiological and cytological) were analyzed by using SPSS 21.   Results: Out of 100 cases, the cause of pleural effusion in 59 patients was tuberculosis, 14 by malignancy, next 14 by Para pneumonic Effusion, 12 by congestive cardiac failure and three cases by alcoholic liver disease. Patients with tuberculous pleural effusion were younger, predominantly males, had unilateral effusion, lower blood hemoglobin, lower Pleural fluid neutrophils, higher pleural fluid Adenosine Deaminase (ADA) levels and higher level of pleural fluid to serum protein ratio as compared to the patients with non-tuberculous effusion.   Conclusion: Tuberculosis is the most common cause of pleural effusion in patients of rural Nepal.

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

scholarly journals Urinothorax Caused by Xanthogranulomatous Pyelonephritis

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Waiel Abusnina ◽  
Hazim Bukamur ◽  
Zeynep Koc ◽  
Fauzi Najar ◽  
Nancy Munn ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Obstructive Uropathy ◽  
Xanthogranulomatous Pyelonephritis ◽  
Robot Assisted ◽  
Rare Form ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Tract Infections

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis that generally afflicts middle-aged women with a history of recurrent urinary tract infections. Its pathogenesis generally involves calculus obstructive uropathy and its histopathology is characterized by replacement of the renal parenchyma with lipid filled macrophages. This often manifests as an enlarged, nonfunctioning kidney that may be complicated by abscess or fistula. This case details the first reported case of xanthogranulomatous pyelonephritis complicated by urinothorax, which resolved on follow-up chest X-ray after robot-assisted nephrectomy.

scholarly journals Clinical profile of patients with pleural effusion admitted to KMCTH

1970 ◽  
Vol 7 (4) ◽  
pp. 438-444 ◽  
Author(s):  
KR Dhital ◽  
R Acharya ◽  
R Bhandari ◽  
P Kharel ◽  
KP Giri ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Clinical Presentation ◽  
Lateral View ◽  
Parapneumonic Effusion ◽  
Age Group ◽  
Common Cause ◽  
Fluid Analysis ◽  
Blood Haemoglobin ◽  
Chest X Ray

Background: pleural effusion is the common findings in patients presenting with cardiopulmonary symptoms but specific studies are lacking in Nepal. Objective: The main objective of this study is to find out the various causes of pleural effusion, their mode of clinical presentation and laboratory analysis of blood and pleural fluid to aid diagnosis of patients with pleural effusion. Materials and methods: Retrospective data from July 2009 to July 2007 from all the cases diagnosed with pleural effusion were taken. Altogether 100 cases diagnosed with pleural effusion by chest X-ray (Posterior- Anterior and Lateral view) and Ultrasonogram of the chest were studied. The following parameters were analysed: Patients demographic profile, causes, location (Unilateral, Bilateral), Blood haemoglobin and count, sputum profile, Monteux test, chest Xray and USG findings and pleural fluid analysis[Biochemical, Haematological, Microbiological(culture and stain) and cytological]. This study was analysed by using SPSS 16. Results: The mean age of the patient was 44.89 ± 21.59 and must patients with pleural effusion belong to age group 21- 30. Most common cause of pleural effusion was found to be tubercular effusion followed by parapneumonic effusion. Right sided effusion was seen in most cases of tubercular parapneumonic and malignant effusion whereas bilateral effusion was seen in 87.5% of the patient (7 out of 8) having congestive heart failure and all cases of renal disease (4 out of 4). Shortness of breath (83%), cough (67%) and fever (66%) are the most common mode of clinical presentation. Conclusion: Our study concluded that the most common cause of unilateral pleural effusion is tuberculosis followed by parapneumonic effusion and most cases of those belong to younger age group (21 -30yrs) and most common cause of bilateral pleural effusion is congestive cardiac failure. Key words: Pleural effusion; Tuberculosis; pneumonia; malignancy; protein; ADA DOI: 10.3126/kumj.v7i4.2772 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 438-444

CT abdomen only for active surveillance in patient with stage I germ cell tumor.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17064-e17064
Author(s):  
Hamed Ahmadi ◽  
Anne K. Schuckman ◽  
Sumeet Bhanvadia ◽  
Hooman Djaladat ◽  
Siamak Daneshmand
Keyword(s):  
Ct Scan ◽  
Tumor Markers ◽  
Active Surveillance ◽  
Physical Exam ◽  
Stage I ◽  
Clinical Recurrence ◽  
X Ray ◽  
History Of ◽  
Chest X Ray

e17064 Background: Surveillance of stage I GCTs includes periodic imaging of chest, abdomen and pelvis. Currently the AUA guidelines recommends CT scan of the abdomen with or without the pelvis as well as chest x ray during active surveillance for these patients. Efforts to modify the surveillance protocols aim to minimize radiation exposure in this young patient population. Per our institutional protocol, we limit cross sectional imaging to CT of the abdomen only during surveillance of stage I disease. Here we report our outcomes to determine whether any recurrence was missed or delayed based on this protocol. Methods: All patient with clinical stage I GCT who have been under active surveillance and completed at least 2 year follow up at our institution were selected using our institutional testis cancer database. Clinical and demographic information were reviewed including recurrence pattern and tumor marker status at time of recurrence. Results: A total of 89 patients who had complete follow up information in the database were included in the study. 49/89 (55%) patients had non-seminoma or mixed GCT histology. 5/89 (5%) patients had history of cryptorchidism and 16/89 (18%) patients had history of inguinal surgery. 14/89 (15%) had relapse at a median of 6.8 months. Recurrence was first detected on surveillance imaging (Imaging recurrence) in 11/14 (78%), by rising tumor markers (marker recurrence) in 2/14 (14%), and on physical exam (clinical recurrence) in 1/14 (7%) patients. Of patients with marker or clinical recurrence, only one had evidence of retroperitoneal recurrence which was detectable by CT abdomen and the other two had lung metastasis detected by chest X ray. Only one patient with imaging recurrence had pelvic lymphadenopathy which was large enough to be seen on CT abdomen. Conclusions: CT scan of the abdomen only in combination with chest imaging, tumor markers and physical exam detected 100% of recurrences in this series. CT pelvis can be safely omitted during active surveillance of stage I GCT. Future modification in guidelines for surveillance protocols of stage I GCT may be warranted with further mounting evidence.

Bilateral spontaneous chylothorax presenting as a left-sided neck mass

2021 ◽  
Vol 14 (4) ◽  
pp. e240320
Author(s):  
Sarah Akbar ◽  
Rajeev Advani ◽  
Rohini Aggarwal
Keyword(s):  
Soft Tissues ◽  
Anterior Chest Wall ◽  
Neck Mass ◽  
Ct Scans ◽  
X Ray ◽  
Low Fat Diet ◽  
History Of ◽  
Chest X Ray ◽  
Inflammatory Changes

A previously well 36-year-old woman presented with a 2-day history of a tender left-sided neck mass associated with left-sided otalgia and odynophagia. On examination, there was a diffuse, tender swelling of the left anterior triangle of the neck with extension onto the anterior chest wall. Ultrasound and CT scans of the neck revealed extensive inflammatory changes in the soft tissues of the neck and a chest X-ray showed blunting of both costophrenic angles. A diagnostic pleural aspiration was subsequently performed and yielded chyle. The patient was commenced on total parenteral nutrition and placed on a low-fat diet; symptoms completely resolved within 5 days, and at follow-up at 6 weeks, there were no further episodes or complications. Bilateral spontaneous chylothorax is a rarely reported phenomenon in the literature; it has been reported in females following the possibility of minor physical exercise such as stretching or hyperextension of the neck.

scholarly journals Recurrent spontaneous pneumothoraces and vaping in an 18-year-old man: a case report and review of the literature

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Alex Bonilla ◽  
Alexander J. Blair ◽  
Suliman M. Alamro ◽  
Rebecca A. Ward ◽  
Michael B. Feldman ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Electronic Cigarettes ◽  
Diagnostic Testing ◽  
Cigarette Use ◽  
Case Presentation ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Tomography Scan

Abstract Background Primary spontaneous pneumothorax is a common disorder occurring in young adults without underlying lung disease. Although tobacco smoking is a well-documented risk factor for spontaneous pneumothorax, an association between electronic cigarette use (that is, vaping) and spontaneous pneumothorax has not been noted. We report a case of spontaneous pneumothoraces correlated with vaping. Case presentation An 18-year-old Caucasian man presented twice with recurrent right-sided spontaneous pneumothoraces within 2 weeks. He reported a history of vaping just prior to both episodes. Diagnostic testing was notable for a right-sided spontaneous pneumothorax on chest X-ray and computed tomography scan. His symptoms improved following insertion of a chest tube and drainage of air on each occasion. In the 2-week follow-up visit for the recurrent episode, he was asymptomatic and reported that he was no longer using electronic cigarettes. Conclusions Providers and patients should be aware of the potential risk of spontaneous pneumothorax associated with electronic cigarettes.

scholarly journals GeneXpert: a game changer in the detection and diagnosis of childhood tuberculosis

2017 ◽  
Vol 5 (1) ◽  
pp. 35 ◽  
Author(s):  
Nayantara Rao Gandra ◽  
Jayasri Helen Gali
Keyword(s):  
Pleural Effusion ◽  
Elbow Joint ◽  
Mantoux Test ◽  
Gastric Aspirate ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
The Government ◽  
Detection And Diagnosis ◽  
Game Changer

Background: Battling against tuberculosis (TB) is still a major challenge in India, despite measures undertaken by the government and medical fraternity. Delay in diagnosing tuberculosis is a challenge, causing hurdle in the prevention of spread of the disease.Methods: This retrospective study analysed the samples by geneXpert assay. Samples (n=403, from 359 children) included pulmonary (sputum and gastric aspirate, 359), extrapulmonary (lymph node aspirate (LNA), 41) cerebrospinal fluid (CSF, 03) pus from the lesion at the elbow joint (01).  Only sputum was analysed for 315 children, both sputum and LNA for 41.Results: Mean age of patients was 9.08±2.85 years, range 3-15 years. There were 221 (61.56%) males and 138 (38.44%) females. Fever (71, 19.78%), fever with cough (87, 24.23%), fever with weight loss (41,11.42%) were the main symptoms.  There were three patients with high fever, headache and seizures with neck rigidity, clinically diagnosed as Tuberculous meningitis. There was history of contact with Tuberculosis in 15 (4.18%) patients. Mean ESR was 112.09mm/1st Hr±56.05 (range 54 -750 mm/1st Hr). Mantoux test was positive in 270 (75.42%). Chest X-ray was normal in 33 (9.19%); consolidation in 189 (52.65%), mild pleural effusion in 94 (26.18%) mild pleural effusion associated with consolidation in 43 (11.98%) were reported. Positive GeneXpert assay (106 samples, 27.39%; sputum (87, 24.23% %), pus (01), CSF (03), LNA (15, 57.69%) was reported in 87 patients.  Results were obtained ≤36 hours, mean 2 hours± 2.34 (range 6- 36 hours).Conclusions: GeneXpert is an effective tool for rapid detection of tuberculosis. Present study supports its inclusion in the battery of routine investigations. It can revolutionise the scenario in prevention and management of tuberculosis. 

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