Autoimmune haemolytic anaemia (AHA) and lung carcinoma.
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Biomedical subjects
Publications and source records attributed to A G Jariwalla.
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Three patients are described who presented to their doctors with a history of coughing up pieces of tissue. These took the form of large bronchial casts and consisted of intrabronchial deposits of clear cell carcinoma. In one patient the pulmonary symptoms preceded the finding of a primary renal carcinoma by four years. The other two patients had undergone nephrectomy for renal carcinoma 13 and four years previously. Expectoration of intrabronchial tumour should alert the physician to the possibility of metastasis from clear cell carcinoma of the kidney.
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A double-blind study of oral metoprolol and propranolol in nine patients with chronic bronchitis (Medical Research Council definition) showed no appreciable deterioration in lung function or significant differences between the two drugs.
Twenty-five patients with an acute exacerbation of chronic bronchitis completed a double-blind trial of amoxycillin 1.5 g v ampicillin 4 g daily. After treatment for one week there was no difference between the treatments in the rates of achieving mucoid sputum, reduction in sputum volume, improvement in peak expiratory flow rate, or duration of hospital stay. In the doses studied ampicillin and amoxycillin are effective drugs of about equal cost.
Fenoterol is a beta 2-sympathomimetic bronchodilator. In a double-blind cross-over trial in 17 asthmatic patients with reversible airway obstruction inhalation of both fenoterol (0.4 mg) and terbutaline (0.5 mg) produced a statistically significant greater increase in peak expiratory flow rate than did placebo. The magnitude and duration of response to fenoterol exceeded that to terbutaline in the doses used. The patients' subjective assessment also suggested the relief of their symptoms with the active drugs. Side effects were minimal.
Two atopic subjects with previously trivial asthma developed severe wheezing after receiving beta-adrenergic blocking agents. These drugs were discontinued but severe airways obstruction was still present more than 18 months later.
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