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Biomedical subjects

J F Beekman

Publications and source records attributed to J F Beekman.

5 recordsLinked to original sources

Pheochromocytoma causing exercise-related headache and pulmonary edema.

A 13-year-old hypertensive girl with a history of severe headaches following exercise developed circulatory collapse after "squat jumps." Pulmonary edema was present without evidence of a cerebral mass. The patient died with increased intracranial pressure despite decompressive craniectomy. Neuropathological evaluation revealed diffuse cerebral edema and a pheochromocytoma in the right adrenal gland. Examination of urine revealed elevation of vanillylmandelic acid levels.

Adolescent

Legionnaires' disease presenting with empyema.

Legionnaire's disease presenting as empyema has not been previously described, although pleural effusions are not uncommon. A 56-year-old woman had a ten-day history of pleuritic chest pain and a large loculated empyema. Legionnaires' disease was documented by serum indirect fluorescent antibody studies.

Diagnosis, Differential

Sarcoidosis: analysis of cells obtained by bronchial lavage.

The cellular content of bronchial lavage was studied in 14 patients with sarcoidosis and 20 normal volunteers. There was no alteration in the total number of cells recovered, except for the expected increase in cellularity in smokers. Nonsmoking patients with sarcoidosis had 19.6 per cent lymphocytes, compared to 8.1 per cent lymphocytes in nonsmoking control subjects. The percentage of alveolar macrophages showing spontaneous adherence of one or more bronchial lymphocytes were, respectively, 10.8 and 8.4 in nonsmoking and smoking patients with sarcoidosis, compared to 1.8 and 2.1, respectively, in nonsmoking and smoking control subjects.

Adult

Spectrum of pleural involvement in sarcoidosis.

Pleural involvement has generally been considered an unusual aspect of sarcoidosis. In this paper, five previously unreported cases of sarcoidosis involving the pleura were discussed. Pleural sarcoidosis may be manifested by the presence of a pleural effusion, and the diagnosis is based on the exclusion of all other possible causes and the demonstration of noncaseating granulomas in the pleura. When the pleura is involved without effusion, it may only be recognized if noncaseating granulomas involving the pleura are looked for specifically. Including the five cases form this study, there have been 73 cases of pleural sarcoidosis reported, but only 37 have been verified by histologic evidence. When strict diagnostic criteria are used, clinical involvement of the pleura in sarsoidosis remains an unusual entity, but it may be that histologic involvement of the pleura is more common than generally appreciated.

Adult