• Title/Summary/Keyword: Respiratory hypersensitivity

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A Case of Hypersensitivity Pneumonitis Caused by Methotrexate (Methotrexate에 의한 약제 유발 과민성 폐렴 1례)

  • Suh, Hyun Joo;Chung, Man Pyo;Park, Eun Ha;Shin, Sung Chul;Jeon, Kyeong Man;Yu, Chang Min;Pyun, Yu Jang;Lee, Kyung Soo;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.203-209
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    • 2004
  • Background : Methotrexate (MTX) has been used to treat a wide range of malignant and benign diseases including osteosarcoma, advanced stage non-Hodgkin's lymphoma, psoriasis, severe rheumatoid arthritis, sarcoidosis, and Wegener's granulomatosis. MTX-induced lung injury occurs in up to 10% of treated patients. Although both acute and chronic presentations have been described, typical manifestation of MTX-induced lung injury is subacute with symptoms usually developing within several months after starting therapy. Nonspecific interstitial pneumonia (NSIP) is the most common histopathologic manifestation of MTX-induced lung disease, while bronchiolitis obliterans organizing pneumonia (BOOP) and diffuse alveolar damage (DAD) are less common. Granuloma formation is reported in 34.7%. In Korea, Two reports of MTX pneumonitis have been published. The one presented with NSIP and the other with DAD. We recently experienced a case of MTX pneumonitis with presentation of hypersensitivity pneumonitis.

A Case of Occupational Hypersensitivity Pneumonitis Associated with Trichloroethylene

  • Jae, Young;Hwang, Eu Dong;Leem, Ah Young;Kang, Beo Deul;Chang, Soo Yun;Kim, Ho Keun;Park, In Kyu;Kim, Song Yee;Kim, Eun Young;Jung, Ji Ye;Kang, Young Ae;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Chung, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.2
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    • pp.75-79
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    • 2014
  • Trichloroethylene (TCE) is a toxic chemical commonly used as a degreasing agent, and it is usually found in a colorless or blue liquid form. TCE has a sweet, chloroform-like odor, and this volatile chlorinated organic chemical can cause toxic hepatitis, neurophysiological disorders, skin disorders, and hypersensitivity syndromes. However, the hypersensitivity pneumonitis (HP) attributed to TCE has rarely been reported. We hereby describe a case of HP associated with TCE in a 29-year-old man who was employed as a lead welder at a computer repair center. He was installing the capacitors on computer chip boards and had been wiped down with TCE. He was admitted to our hospital with complaints of dry coughs, night sweats, and weight losses for the past two months. HP due to TCE exposure was being suspected due to his occupational history, and the results of a video-associated thoracoscopic biopsy confirmed the suspicions. Symptoms have resolved after the steroid pulse therapy and his occupational change. TCE should be taken into consideration as a potential trigger of HP. Early recognition and avoidance of the TCE exposure in the future is important for the treatment of TCE induced HP.

A Case of Bronchospasm after Intravenous Hydrocortisone Succinate injection in an Asthmatics (Hydrocortisone 정주후 기관지수축이 발생한 기관지 천식 1예)

  • Lee, Young-Soo;Yong, Suk-Joong;Shin, Kye-Chul;Joo, Yong-Jin;Kim, Kwang-Ho;Lee, Sang-Chul;Han, Byung-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.568-573
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    • 1994
  • Corticosteroids are widely used in the treatment of various diseases because of its potent antiinflammatory effect. According to recent knowledge, bronchial asthma is also chronic inflammatory disease. Therefore antiinflammtory agent such as cromoyln sodium and corticosteroid is highly recommended for treament of chronic bronchial asthma. Especially hydrocortisone succinate (Solu-Cortef) is commonly used for treament to acute asthmatic attack via intravenous injection due to have rapid therapeutic onset and short duration. Since Sunaga et al. reported acute asthma attack after hydrocortisone injection in 1973, several cases of bronchospam with or without angioedema and urticaria after intravenous injection of hydrocortisone have been reported. We experienced a case of severe bronchospasm and acute respiratory failure after intraveous injection of hydrocortisone succinate in 64 year-old female asthmatic patient who visited to emergency room for acute asthmatic attack. About 5 minites after Solu-Cortef injection, a severe bronchospasm with arterial hypoxemia was developed. In order to confirm the suspected relationship between the offending drug(Solu-Cortef) and acute bronchospasm, we examed intravenous and inhalation provocation test by hydrocortisone succinate and methylprednisolone(control). After administration of hydrocortisone succinate via intravenous and inhalation route, severe asthmatic attack occurred. But administration of intravenous methylprednisolone and orall triamcinolone and saline were not provoke bronchospasm. Skin test using hydrocortisone sodium succinate was also positive. Administration of hydrocortisone is very serious to asthmatic patient with hydrocortisone hypersensitivity. Therefore, the clinician must be have history taking about previous adverse reaction of steroid before its clinical use. And methylprednisone may be useful and safe drug to the treatment of acute asthmatic patient with hydrocortisone hypersensitivity.

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A Case of Drug-Induced Interstitial Pneumonitis Caused by Valproic Acid for the Treatment of Seizure Disorders

  • Kim, Se Jin;Jhun, Byung Woo;Lee, Ji Eun;Kim, Kang;Choi, Hyeun Yong
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.145-148
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    • 2014
  • Valproic acid is one of the most common antiepileptic drugs used for the treatment of several seizure disorders. A 20-year-old man presented with a sudden decline of consciousness. He had a neurosurgery operation for intracranial and intraventricular hemorrhage. Following surgery, antiepileptic medication was administered to the patient in order to control his seizure events. On valproic acid treatment, he began to complain of fever and dyspnea. His symptoms persisted despite receiving empirical antibiotic treatment. All diagnostic tests for infectious causes were negative. A high-resolution computed tomography scan of the chest revealed predominantly dependent consolidation and ground-glass opacities in both lower lobes. The primary differential was drug associated with interstitial lung disease. Therefore, we discontinued valproic acid treatment and began methylprednisolone treatment. His symptoms and radiologic findings had significantly improved after receiving steroid therapy. We propose that clinicians should be made aware of the potential for valproic acid to induce lung injury.

Diagnosis of Hypersensitivity Pneumonitis: 2020 Clinical Practice Guideline (2020년 개정 진료 치침에 따른 과민성폐렴의 진단)

  • Soojung Park;Yu-Whan Oh;Eun-Young Kang;Hwan Seok Yong;Cherry Kim;Ki Yeol Lee;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.817-825
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    • 2021
  • Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.

Correlation between Oriental Medicine Diagnosis and the Autonomic Nervous System Functions of Hyperhidrosis Patients (다한증 환자의 한의학적 변증특성 및 자율신경계 기능과의 상관관계)

  • Lee, Sung-Hun;Kim, Jae-Hwan;Roh, Yeong-lae;Rhee, Hyung-Koo;Jeong, Seung-Yeon;Jung, Sung-Ki;Jung, Hee-Jae
    • The Journal of Internal Korean Medicine
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    • v.29 no.2
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    • pp.359-374
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    • 2008
  • Objective : Hyperhidrosis is a condition characterized by excessive sweating. Some studies suggest that hyperhidrosis is associated with autonomic nervous system dysfunction. Hyperhidrosis is often accompanied by hypersensitivity, tension, irritability, heat flashes, fatigue, etc. This study was designed to evaluate the correlation between Oriental Medicine diagnosis and the autonomic nervous system function in patients with hyperhidrosis using Heart Rate Variability (HRV) analysis. Methods : 23 palmar and plantar hyperhidrosis patients and 10 systemic hyperhidrosis patients were recruited and evaluated by Oriental Medicine diagnostic questionnaire and HRV analysis. The Oriental Medicine diagnostic questionnaire used a three-dimensional diagnosis that classified patients into Cold or Heat Syndrome, Yin or Yang Syndrome, and Deficiency or Excess Syndrome. Measured indices of HRV used the frequency domain analysis(i.e. TP, VLF, LF, HF and LF/HF ratio). Also, measure indices of HRV adjusted for aging effects were evaluated. Results : Cold/Heat Syndrome was not associated with hyperhidrosis prevalence nor the HRV analysis in hyperhidrosis patients. The Yang Syndrome group(78.8%) was more strongly correlated than the Yin Syndrome group(21.2%), and character of Yang was correlated with the adjusted TP and adjusted LF. The LF/HF ratio in the Excess Syndrome group was significantly higher than the LF/HF ratio in the Deficiency Syndrome group. Conclusion : Hyperhidrosis was not associated with the Cold/Heat Syndrome, but was found to be closely associated with the Yang Syndrome. The LF/HF ratio was significantly higher in the Excess Syndrome group than in the Deficiency Syndrome group in hyperhidrosis patients.

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Ultrasonographic Examination for Intrahepatic Porto-systemic Shunts in Dogs (개의 간내성 문맥-전신성 단락의 초음파적 고찰)

  • 최지혜;안용주;이희천;황국진;이영원;엄기동;윤화영;최민철;권오경
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.514-518
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    • 1999
  • Portosystemic shunts in 3 Dogs with respiratory sign of cough and with dementia signs characterized by hypersensitivity, salivation, and seizure were diagnosed at veterinary teaching hospital of Seoul National University. In radiographs, microhepatica was observed. In abdominal ultrasonography, abnormal intrahepatic connections between the portal vein and the systemic vessels and tortuous vascularity were found. There was no complication such as ammonium urate urolith in kidney or urinary bladder, These dogs were treated with medicine and protein-restricted diet.

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A case of a 6-year-old boy diagnosed with lipid transfer protein syndrome using the ImmunoCAP and ImmunoCAP Immuno Solid-phase Allergen Chip

  • Sang Hoon Lee;Yoon Ha Hwang
    • Allergy, Asthma & Respiratory Disease
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    • v.12 no.1
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    • pp.31-34
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    • 2024
  • We experienced a rare case of a 6-year-old boy who was suspected of having lipid transfer protein (LTP) syndrome; the patient was diagnosed with LTP syndrome using the ImmunoCAP/ImmunoCAP Immuno Solid-phase Allergen Chip (ISAC) test. LTP syndrome affects patients who are already sensitized to pollens with signs and symptoms of allergic rhinitis with or without bronchial asthma. Its severity is closely associated with the geographical location as well as the level, nature, and duration of the allergen exposure in a susceptible individual with or without cofactors, such as exercise, alcohol, chemicals, or nonsteroidal anti-inflammatory drug. Patients with LTP syndrome may present with diverse manifestations ranging from local symptoms, such as mild contact urticaria, oral allergy syndrome, or gastrointestinal problems, to anaphylaxis and even anaphylactic shock. Our case highlights the usefulness of the ImmunoCAP/ImmunoCAP ISAC test in establishing a diagnosis of LTP syndrome.

Milk Allergens (우유의 알레르기 유발물질)

  • Kim, So-Young;Oh, Sang-Suk;Ham, Jun-Sang;Seol, Kuk-Hwan;Kim, Hyoun-Wook;Han, Sang-Ha;Choi, Eun-Young;Park, Beom-Young;Oh, Mi-Hwa
    • Journal of Dairy Science and Biotechnology
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    • v.30 no.1
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    • pp.17-22
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    • 2012
  • Since the prevalence of allergies is increasing, food allergy is a major concern for consumers, as well as for the food industry. The foods that account for over 90% of all moderate to severe allergic reactions to food are milk, eggs, peanuts, soybeans, fish, shellfish, wheat, and tree nuts. Of these food allergens, milk is one of the major animal food allergens in infants and young children. Milk is the first food that an infant is exposed to; therefore, the sensitization rate of milk in sensitive individuals is understandably higher. The mechanisms involved in allergic reactions caused by this hypersensitivity are similar to those of other immune-mediated allergic reactions. The reactions occur in the gastrointestinal tract, skin, and respiratory tract, with headaches and psychological disorders occurring in some instances. The major allergenic proteins in milk are casein, ${\beta}$-lactoglobulin, and ${\alpha}$-lactalbumin, while some of the minor allergenic proteins are lactoferrin, bovine serum albumin, and immunoglobulin. Reliable allergen detection and quantification are essential for compliance with food allergen-labeling regulations, which protect the consumer and facilitate international trade.

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Association of PTGER gene family polymorphisms with aspirin intolerant asthma in Korean asthmatics

  • Park, Byung-Lae;Park, Se-Min;Park, Jong-Sook;Uh, Soo-Taek;Choi, Jae-Sung;Kim, Yong-Hoon;Kim, Mi-Kyeong;Choi, In-Seon S.;Choi, Byoung-Whui;Cho, Sang-Heon;Hong, Chein-Soo;Lee, Yong-Won;Lee, Jae-Young;Park, Choon-Sik;Shin, Hyoung-Doo
    • BMB Reports
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    • v.43 no.6
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    • pp.445-449
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    • 2010
  • Aspirin-intolerant asthma (AIA) is characterized by severe asthmatic attack after ingestion of aspirin and/or non-steroidal anti-inflammatory drugs. In this study, we investigated the relationship between Prostaglandin E2 receptor (PTGER) gene family polymorphisms and AIA in 243 AIA patients and 919 aspirin-tolerant asthma (ATA) controls of Korean ethnicity in two separate study cohorts. After genotyping 120 SNPs of the PTGER gene family for the $1^{st}$ cohort study, four SNPs in PTGER1, ten in PTGER3, six in PTGER3, and a haplotype of PTGER2 showed association signals with decreased or increased risk of AIA. Among the positively associated SNPs, one in PTGER1 and four in PTGER3 were analyzed in the $2^{nd}$ cohort study. The results show that rs7543182 and rs959 in PTGER3 retained their effect, although no statistical significance was retained in the $2^{nd}$ cohort study. Our findings provide further evidence that polymorphisms in PTGER3 might play a significant role in aspirin hypersensitivity among Korean asthmatics.