PubMed Health⌕ Search

Biomedical subjects

M Amthor

Publications and source records attributed to M Amthor.

At least 19 recordsLinked to original sources
PubMed2005

[Chronic cough and pulmonary infiltration].

HISTORY: A 56-year-old man complain of chronic cough for 6 months without further clinical problems. The patient was otherwise in good health and showed only a moderate bronchial sound at the left ventral paracordial region. INVESTIGATIONS: Thorax X-ray revealed an infiltrate in the lingula with segmental borders. The CT scan showed air bronchogramms and bilateral more small infiltrates. DIAGNOSIS, TREATMENT, CLINICAL COURSE: Bronchoscopic transbronchial biopsies revealed a BALT-lymphoma. A seven years old chest X-ray showed the lingual infiltrate in nearly the same extension as the current X-ray. Because of the disseminated manifestation, the slow course and the good performance status we did not start a palliative chemotherapy so far. CONCLUSION: Any pulmonary infiltrate which looks like pneumonia must be given a definite diagnosis if there are no clinical signs of infection.

Biopsy↗
PubMed2004

[Uncommon course of radiation-induced pneumonitis with subsequent bronchiolitis obliterans with organizing pneumonia (BOOP) in a female with breast cancer].

Radiation-induced pneumonitis is a familiar complication of breast cancer radiotherapy, whereas bronchiolitis obliterans with organizing pneumonia occurs extremely rarely after this treatment. Consequently, testing for BOOP is rarely included in differential diagnosis. This results in delayed diagnosis, so that treatment is ultimately commenced too late. The infiltrations are often located in the unirradiated lung, impeding diagnosis. The radiotherapy-induced BOOP-reaction that can also occur after typical radiation pneumonitis is illustrated by reference to a characteristic case report.

Breast Neoplasms↗
PubMed2001

Interstitial lung disease induced by endogenous Candida albicans.

We report on a 64-year old woman with an interstitial lung disease which had characteristics of hypersensitivity pneumonitis. Severe febrile attacks with impairment of ventilation and diffuse poorly defined radiodensities and ground glass opacities on chest x-ray occured repeatedly. Laboratory data showed hypoxemia, leukopenia and circulating Candida albicans (C.a.)-antigen. Bronchoalveolar lavage revealed an increase in neutrophils. Transbronchial biopsies showed lymphocytic alveolitis, bronchiolitis obliterans and epitheloid cell granulomas. IgG and IgA and the lymphocyte proliferation assay were positive with C.a.-antigen. C.a. was detected in the feces. Intradermal skin test with C.a. showed a positive immediate and late phase reaction and inhalative provocation test with C.a.-antigen was positive. After antimycotic treatment the symptoms resolved completely and long-lasting. We conclude that the disease was induced by C.a.-antigen reaching the lungs from the intestinal tract via the bloodstream.

Antifungal Agents↗
PubMed2001

[Non-tubercular mycobacterial infection of the lungs due to Mycobacterium smegmatis].

Nontuberculous mycobacteriosis due to M. smegmatis is a rarity. We report on the case of a 51 year old male HIV-seronegative patient without predisposing bronchopulmonary disease, but with a state after gastrectomy and splenectomy who developed unproductive cough, night sweat and weight loss. The chest radiograph and thoracic CT showed wide-spread bilateral patchy infiltrations. Histological examination of transbronchial biopsies revealed chronic carnificating pneumonia. A perhoracic fine-needle biopsy showed caseating epitheloid cell granulomas with acid fast bacilli. These were identified as M. smegmatis by PCR with subsequent sequencing. Acid fast bacilli could not be detected microscopically neither in sputum nor in bronchial secretions, however M. smegmatis has been repeatedly detected by culture in these materials. In neither material tubercle bacilli have been detected by nucleic acid amplification (NAT) or culture. Immunologic investigations revealed a reduced number of CD4+ lymphocytes and a reduction of interferon alpha- and -gamma-synthesis by peripheral blood mononuclear cells. Treatment with Rifabutin, Ethambutol, Clarithromycin and Ofloxacin resulted in complete clinical and roentgenological resolution.

CD4-Positive T-Lymphocytes↗
PubMed2000

Hypersensitivity alveolitis induced by endogenous candida species

We report the case of a 64-year old woman with severe attacks of allergic alveolitis occurring frequently independent of a concrete place. These attacks were regularely preceded by diarrhoe. Laboratory data showed marked leukopenia and circulating Candida albicans (C.a.)-antigen. Bronchoalveolar lavage revealed an increase in neutrophils (13%). Transbronchial biopsies showed focal alveolitis and focal septal fibrosis with bronchiolitis obliterans and an epitheloid cell granuloma. Immunohistochemical examination revealed C.a.-antigen in alveolar macrophages. In the faeces a high amount of C.a. and C. glabrata was detected. In serum IgG and IgA were positive against C.a., IgE against C.a. was negative. Lymphocyte proliferation assay with C.a.-antigen was positive. Intradermal skin test with C.a. showed positive immediate and late phase reaction. Furthermore inhalation challenge with C.a.-antigen was positive. A febrile reaction with chills, dyspnea and hypoxemia and leukocytosis in peripheral blood occured after 6 hours. Lung function showed a predominantly obstructive impairment of ventilation. An extensive search for other IgG- or IgE-mediated allergies (other fungi, environmental or food allergens) was completely negative. Investigation of the gastrointestinal tract did not show any abnormality exept the detection of lactose intolerance. There was no fungal growth in the patients flat. After initiation of antimycotic treatment the symptoms resolved completely. - We conclude that the disease was induced by C.a.-antigen reaching the lungs from the intestinal tract via the bloodstream. It is still a matter of debate whether an additional factor is necessary for the antigen to penetrate the intestinal mucosa.

Journal Article↗
PubMed2000

Intermittent activity-induced hemobilia caused by liver hemangioma.

BACKGROUND: Intestinal bleeding of unknown origin can lead to a difficult workup. Abdominal colic, melena/hematemesis, and jaundice represent the pathognomonic triad for hemobilia, but clinical presentation and etiology of this entity are varying. Seldom all of these symptoms are present, and rarely does hemobilia cause melena or hematemesis. Often the correct diagnosis is missed. Patients frequently have a long history of complaints and inadequate therapy. CASE REPORT: We report on a patient who complained of repeated, severe epigastric pain and massive melena induced by exercise activity. After 2 years of complaints and an unnecessary operation, ultrasound detected a liver hemangioma. It was supposed that the hemangioma was causing hemobilia during strenuous physical activity. The patient underwent a partial liver resection to eliminate the hemangioma. All complaints resolved, and the patient remained asymptomatic postoperatively. CONCLUSIONS: Physicians should be aware of hemobilia as a rare cause of upper gastrointestinal bleeding, especially if esophagogastroduodenoscopy cannot demonstrate any bleeding source. Ultrasound is able to visualize many diseases leading to hemobilia and should be integrated into the early workup of unclear intestinal bleedings.

Adult↗
PubMed1998

[Spinach powder-induced exogenous allergic alveolitis].

A 51-year old woman developed hypersensitivity pneumonitis to spinach powder, which is used as a food dye. The diagnosis was confirmed by demonstration of IgG2-antibodies in the patient's serum to distinct bands of spinach extract by Western blotting. Furthermore an exposure test with the natural allergen was positive. Severe disease with fever, chills and dyspnoea developed after inhalation of native spinach powder. Arterial pO2 dropped significantly and pulmonary function tests showed severe restrictive impairment and reduction of diffusion capacity. Leucocyte count and the serum concentrations of the cytokines TNF alpha and IL6 and of the soluble IL2-receptor rose significantly in peripheral blood, whereas the concentration of neopterine did not change. 24 hours after exposure bronchoalveolar lavage showed an increase of neutrophils. In lung parenchyma mononuclear interstitial infiltrates and an epitheloid cell granuloma were seen.

Alveolitis, Extrinsic Allergic↗
PubMed1997

Crohn's disease and sarcoidosis: systemic granulomatosis?

We report an unusual case of severe Crohn's disease with involvement of the lung. In 1993 at age 21 a male patient experienced a Helicobacter-negative duodenitis. A routine chest radiograph revealed spotted opacities in the right upper lobe without discomfort and normal pulmonary function except for a reduced diffusion capacity. Bronchoalveolar lavage showed mild lymphocytosis and biopsies from the macroscopically normal bronchi displayed non-caseating granulomas. In 1995 he had symptoms of peptic ulcer disease with a gastric outlet stenosis. He underwent Billroth I resection with only temporary improvement. Three months later the symptoms had recurred and a stenosing inflammatory process of the duodenum was seen on endoscopy suggesting Crohn's disease. A chest radiograph demonstrated infiltrations in parts of the left lung and bronchoalveolar lavage again revealed alveolar lymphocytosis (CD4/CD8 ratio 3.1). Both the gastrointestinal and pulmonary affections responded to corticosteroids but the duodenal stricture had to be resected. The association of Crohn's disease and pulmonary disorders is discussed.

Adrenal Cortex Hormones↗
PubMed1992

[Uterine metastases of malignant melanoma].

Uterine metastases of extragenital malignomas are rarely presented in literature. Malignant melanoma as primary tumour is described more often than can be expected with regard to its relative incidence in comparison to other malignomas. If the uterus is involved in melanoma disease, mostly cervix and myometrium are affected, endometrial metastases are considered to be very rare. If the primary tumour is known, bleeding abnormalities frequently lead to the diagnosis of uterine metastases, but occasionally abnormal bleeding appears to be the first symptom of melanoma disease. In the following another such case is described and an additional case of endometrial metastases of malignant melanoma is presented.

Aged↗
PubMed1992

[Invasive aspergillosis in cavitary lung sarcoidosis].

Pulmonary sarcoidosis is a granulomatous disorder of unknown origin with a favorable outcome in most patients. However in about 5-10% progressive fibrosis is observed and may lead to further complications. We report on a 49 year-old woman with sarcoidosis with fibrotic changes and cavities in both upper lobes, who developed an upper lobe infiltration resistant to antibiotic treatment. Histologic examination of bronchial biopsy specimen revealed invasive aspergillosis. Therapy with Amphotericin B and Flucytosin was followed by marked clinical and radiological improvement.

Aspergillosis↗
PubMed1991

[Cryptococcal sepsis simulating miliary tuberculosis in malignant lymphoma].

A malignant non-Hodgkin lymphoma (Cb-Cc) stage IVb was diagnosed in a man of 71 years of age. He was subjected to polychemotherapy. The mediastinum was irradiated. Cortisone therapy was performed because of irradiation pneumonitis. A highly febrile disease pattern developed with increasing dyspnoea while displaying the signs and symptoms of a miliary pulmonary disease. The treatment course was directed at combatting miliary tuberculosis. The patient died from cardiorespiratory failure. The postmortem examination supplied proof of cryptococcal sepsis. The differential diagnosis is discussed.

Aged↗
PubMed1979

[Liebow's desquamative pneumonia--a separate disease entity or a form of chronic interstitial pneumonia? (author's transl)].

When in 1965 Liebow first described desquamative interstitial pneumonia (DIP) and differentiated it from other types of interstitial pneumonia he believed it to be a separate disease entity. The fact that the observed cases were of a relatively benign nature seemed to confirm this view. However, during the past years there have been reports of cases which took a less benign course; it was also observed that disorders with features similar to DIP could be produced by various exogenous noxae. The question, therefore, arises, whether DIP is, in fact, a separate disease entity or a specific pulmonary reaction to a variety of similarly acting noxae.

Humans↗
PubMed1979

[Long-term follow-up of lung function parameters in patients with idiopathic pulmonary fibrosis treated with prednisone and azathioprin or d-penicillamine (author's transl)].

The prognosis of idiopathic pulmonary fibrosis is poor, it amounts to 4-6 years (after beginning of the symptoms). Spontaneous remissions are very rare, the corticosteroid monotherapy shows a certain success in only 11-16-20% of the cases. Therefore, since 1970 we carry out a combined therapy (see above); the results, confirmed by pulmonary function tets (vital capacity, static compliance, pO2 at rest and after exercise) will be presented. In summary: (1) Azathioprin and Prednisone: After a treatment of 2 years: 6 patients improved, 2 deteriorated, 3 died; the corresponding figures after 4 years were 6/1/4, after 6 years 3/-/5, after 8 years 2/-/3; (2) D-Penicillamine and Prednisone: After 2 years 3/2/4, 1 unchanged; after 4 years 1/-/4, 1 unchanged. The results of the therapy are discussed especially regarding prognosis of the disease and used drugs.

Azathioprine↗