Lung toxicity associated with cyclophosphamide use is a rare but serious side effect, that may result in a fatal course. However no such cases have been reported in Korea, so clinicians would not be alert to this adverse effect. We recently experienced a woman with Wegener's granulomatosis and idiopathic pulmonary fibrosis. This patient had been administered 12 grams of cyclophosphamide for 4 months. At that time of admission, She felt aggravating dyspnea on exertion for 2 weeks. Her chest x-ray and high resolution CT revealed aggravated reticular opacities and ground glass appearances. Dyspnea was improved and ground glass appearances on HRCT was disappeared after discontinuation of cyclophosphamide. We diagnosed this case as cyclophosphamide-induced pneumonitis and report it with a brief review of the literature.
Cyclophosphamide* ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Female ; Glass ; Humans ; Idiopathic Pulmonary Fibrosis ; Korea ; Lung* ; Pneumonia ; Thorax ; Wegener Granulomatosis*

BACKGROUND: Previous findings demonstrated that the expression of cytotoxic effector molecules is increased in acute rejection of renal allografts. In the present study, we serially examined the gene expression of perforin, granzyme B and Fas ligand(FasL) in peripheral blood lymphocytes(PBLs) of renal allograft recipients to assess the potential of their expression as a marker of acute rejection. METHODS: PBLs were isolated from blood samples taken on days 2, 4, 6, 8, 10 and 12 after transplantation. Competitive PCR was performed to evaluate the abundance of mRNA of perforin, granzyme B and FasL. The mean value of each molecule plus 2 SD for the control group was set as a discriminatory level. RESULTS: When all measured samples were compared, perforin expression was significantly higher in patients with acute rejection than in the control group(1.84+/-3.01 versus 0.71+/-0.48, p=0.01). The percentage of perforin expression exceeding the discriminatory level was also significantly higher in patients with acute rejection(p=0.0003). Five patients in the rejection group(5/7, 71.4%) showed perforin expression exceeding the discriminatory level, while only 1 patient in the control group did so(1/8, 12.5%)(p= 0.02). Perforin expression of days 0 and 1 of rejection crisis was the highest over the study period. No consistent pattern of granzyme B and FasL expression was identified in relation to rejection crisis. CONCLUSION: Gene expression of perforin by PBLs was upregulated in accordance with acute rejection, thus offering the possibility that it may be utilized as a marker of acute rejection.
Allografts* ; Gene Expression ; Granzymes* ; Humans ; Kidney Transplantation ; Lymphocytes* ; Perforin ; Polymerase Chain Reaction ; RNA, Messenger

Catamenial hemoptysis is a term used to describe recurrent hemoptysis occuring at the time of menstruation and is caused by the presence of thoracic endometriosis. The diagnosis is almost always established on the clinical grounds and by exclusion of other causes of recurrent hemoptysis. The pathogenesis of the thoracic endometriosis is not clear but several hypothesis have been proposed, such as retrograde flow of the endometrial tissue through the diaphragmatic defects, microembolization through pelvic veins and differenciation into endometrial tissues. We report a case of a 35-year-old woman who presented with catamenial hemoptysis caused by the endometriosis of lung parenchyme. The lesion was localized to the right upper lobe posterior segment and right lower lobe superior segment by the computerized tomogram of the chest during the time of mensturation and treated effectively with bisegmental wedge resection.
Adult ; Diagnosis ; Endometriosis* ; Female ; Hemoptysis* ; Humans ; Lung* ; Menstruation ; Thorax ; Veins