Internal medicine
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Review Case Reports
Acute eosinophilic pneumonia following cigarette smoking: a case report including cigarette-smoking challenge test.
A 21-year-old woman presented with acute progressive dyspnea. Chest computed tomography (CT) revealed diffuse bilateral infiltrates. ⋯ Therefore, a cigarette-smoking challenge test was done with the patient's informed consent. After the challenge, eosinophilic pneumonia was documented by BALF and TBLB findings, which were similar to those detected on admission, without significant radiographic findings.
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Review Case Reports
Two cases of Sjögren's syndrome with multiple bullae.
Here, we report two rare female cases of Sjögren's syndrome with multiple bullae, involving a 66- and a 51-year-old. Neither had any obvious pulmonary complaint. Chest radiographs and high-resolution CT (HRCT) scans showed interstitial linear and nodular opacities and multiple bullae. ⋯ In the first case the bullae decreased in size with corticosteroid treatment. Airway narrowing due to peribronchiolar mononuclear cell infiltration causes a check-valve mechanism, which may lead to bullae formation. Although a rare occurrence, it is important to recognize that cystic or bullous lung disease can accompany Sjögren's syndrome.
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Review Case Reports
Retroperitoneal fibrosis associated with membranous nephropathy effectively treated with steroids.
Corticosteroids were successfully used to treat a 66-year-old man with retroperitoneal fibrosis (RPF) and previously diagnosed membranous nephropathy. Proteinuria was noted at the age of 51 years, and membranous nephropathy was diagnosed by renal biopsy. Ten years later, he presented with right hydronephrosis and renal dysfunction, and was diagnosed as having RPF based on the typical diagnostic imaging findings. ⋯ The hydronephrosis recurred three years later, but corticosteroids were again effective in improving ureteral obstruction. This was a rare case of recurrent RPF with membranous nephropathy in which steroid therapy was effective in treating pleural effusion and hypergammaglobulinemia during the clinical course. This case suggests that an immunological disorder is involved in the pathogenesis of RPF.
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Editorial Comment Review
Is homocysteine an independent cardiovascular risk factor also in Japanese?