Adolescent ; Female ; Glomerulonephritis, Membranous ; etiology ; Humans ; Tuberculosis, Pulmonary ; complications

Humans ; Pulmonary Disease, Chronic Obstructive ; complications ; etiology ; Smoking ; adverse effects ; Tuberculosis, Pulmonary ; complications ; etiology

In order to ascertain the role of TNF-alpha in pulmonary tuberculosis, we determined the TNF-alpha productivity of alveolar macrophages(AMs) obtained by bronchoalveolar lavage(BAL), along with the level of TNF-alpha in the serum of patients with tuberculosis including pulmonary, miliary, and endobronchial tuberculosis, healthy controls, and pulmonary diseases such as diffuse interstitial lung disease (DILD) and pneumonia. AMs from patients with pulmonary tuberculosis did not produce a larger amount of TNF-alpha than did those from the healthy control subjects. However, among the patients with pulmonary tuberculosis, the AMs from the fresh and reactivated groups produced a larger amount of TNF-alpha than those from the inactive group. AMs from patients showing positivity in culture produced a larger amount of TNF-alpha than those showing negativity. The average level of serum TNF-alpha in patients with pulmonary tuberculosis was slightly higher than that of the healthy control group. Among patients with pulmonary tuberculosis, significantly increased levels of serum TNF-alpha were noted in the reactivated group compared to those of the fresh and inactive group. Patients with moderate to far-advanced infiltration on their chest X-rays, showed a significantly higher level of serum TNF-alpha than those with minimal involvement on the chest X-ray. Smokers from the healthy control group showed a significantly higher level of serum TNF-alpha than non-smokers from the same group. These results suggest that an increase in the production of TNF-alpha may correspond with the severity of pulmonary tuberculosis.
Bronchoalveolar Lavage Fluid/metabolism ; Humans ; Macrophages/metabolism ; Pulmonary Alveoli/metabolism ; Tuberculosis, Miliary/metabolism ; Tuberculosis, Pulmonary/etiology/*metabolism ; Tumor Necrosis Factor-alpha/*biosynthesis

Adult ; Aspergillosis ; etiology ; Humans ; Male ; Pulmonary Alveolar Proteinosis ; etiology ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Tuberculosis ; complications

Adult ; Aspergillosis ; diagnosis ; etiology ; Diagnostic Errors ; Humans ; Lung Diseases, Fungal ; diagnosis ; etiology ; Male ; Silicosis ; diagnosis ; microbiology ; Silicotuberculosis ; diagnosis ; etiology ; Tuberculosis, Pulmonary ; diagnosis ; etiology

Cachexia ; etiology ; Cough ; Delayed Diagnosis ; Fever ; Humans ; Hypercalcemia ; etiology ; Male ; Middle Aged ; Radiography ; Renal Dialysis ; Renal Insufficiency ; etiology ; therapy ; Tuberculosis, Pulmonary ; complications ; diagnostic imaging

Hemophagocytic lymphohistiocytosis (HLH) was a life-threatening syndrome due to the uncontrolled immune activation of cytotoxic T lymphocytes, natural killer (NK) cells, and macrophages. HLH is characterized by primary and secondary causes, the early diagnosis and treatment of patients are closely related to the prognosis and clinical outcome of patients. The clinical presentation is variable but mostly includes prolonged fever, splenomegaly, coagulopathy, hypertriglyceridemia, and hemophagocytosis, none of them is specific and particular for HLH. Tuberculosis (TB) infection is one of the causes of HLH. HLH caused by TB is very rare clinically, but it has a high mortality. For patients with fever of unknown origin, HLH-related clinical manifestations sometimes present before the final diagnosis of TB, and HLH is associated with the most significant mortality rate. This article is mainly about a 28-year-old patient with HLH who suffered from severe TB infection. The patient attended a hospital with a history of 2 months of prolonged fever, 10 days booger and subcutaneous hemorrhage in lower limbs. Before this, he was in good health and denied any history of tuberculosis exposure. Combined with relevant laboratory test results (such as splenomegaly, hemoglobin, platelet count, and hypertriglyceridemia) and clinical manifestations (e.g. fever), the patient was diagnosed with hemophagocytic lymphohistiocytosis, but the etiology of HLH remained to be determined. To confirm the etiology, the patient was asked about the relevant medical history (intermittent low back pain) and was performed chest CT scan, bone marrow biopsy, and fundus photography. Finally, he was diagnosed with hemophagocytic lymphohistiocytosis caused by hematogenous disseminated pulmonary tuberculosis. In response to this, intravenous methylprednisolone and anti-tuberculosis treatment (isoniazid, pyrazinamide, moxifloxacin, and amikacin) were administered to the patient. After more than a month of treatment, the patient recovered from HLH caused by severe TB infection. Therefore, this case suggests that we should be vigilant to the patient who admitted to the hospital with fever for unknown reasons, to diagnose HLH as early as possible and clarify its cause, then perform interventions and treatment, especially HLH secondary to tuberculosis. Also, cases of atypical TB and severe TB should be carefully monitored to achieve early diagnosis and early intervention.
Male ; Humans ; Adult ; Lymphohistiocytosis, Hemophagocytic/diagnosis* ; Splenomegaly ; Tuberculosis, Pulmonary/diagnosis* ; Bone Marrow/pathology* ; Fever/etiology* ; Hypertriglyceridemia/complications*

Pulmonary lymphangioleiomyomatosis has been observed almost exclusively in women, usually in their reproductive years. Exacerbations with pregnancy and after hormonal manipulation have been documented, and it has been suggested that its pathogenesis is due to the influence of hormonal(estrogenic) stimulus. The clinical, roentgenographic, and histopathologic features of this case of pulmonary lymphangioleiomyomatosis in a 22-year-old male are all characteristic of those described in prior reports, except for the patient's sex. With the following case of pulmonary lymphangioleiomyomatosis in a male, we suggest the possibility of the existence of an additional pathogenetic mechanism.
Adult ; Emphysema/complications ; Humans ; Lung Neoplasms/complications/etiology/*pathology ; Lymphangiomyoma/complications/etiology/*pathology ; Lymphatic System/pathology ; Male ; Muscle, Smooth/pathology ; Thoracotomy/adverse effects ; Tuberculosis, Pulmonary/complications

Aged, 80 and over ; Antitubercular Agents ; therapeutic use ; Biopsy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Mycobacterium tuberculosis ; isolation & purification ; Pneumonia, Lipid ; diagnosis ; drug therapy ; etiology ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; diagnosis ; drug therapy ; etiology ; Zenker Diverticulum ; complications ; diagnosis

Disseminated superficial porokeratosis (DSP) is a rare cause of secondary cutaneous amyloidosis. An 83-year-old male patient showed an increase in both size and number of DSP lesions after contracting pulmonary tuberculosis. The DSP lesions of the patient consisted of numerous annular eruptions on both sun-exposed and sun-protected areas, which occurred over a period of 20 years. Multiple skin biopsies were taken from normal or lesional/sun-exposed or sun-protected skin samples. Histopathologic examination included routine H+ACY-E stains, Congo red stains, thioflavin-T stains and anticytokeratin antibodies (AE1, AE3). And the results were as follows+ADs- 1) Positive staining with Congo red and thioflavin-T indicated an amyloid nature for the deposits, 2) confinement of the amyloid deposition just below the lesional epidermis (while sparing the neighboring uninvolved or distant normal skin) indicated some role of the lesional epidermis, and 3) positive staining with AE3 further indicated an epidermal origin-type II epithelial keratin-of the amyloid. We present a case of DSP with a local amyloid deposit, characterized by association of positive familial background, severe pruritus and pulmonary tuberculosis.
Aged ; Aged, 80 and over ; Amyloid/analysis ; Amyloidosis/etiology+ACo- ; Case Report ; Congo Red ; Dyes ; Epidermis/chemistry ; Human ; Male ; Porokeratosis/complications+ACo- ; Pruritus/etiology ; Skin Diseases/etiology+ACo- ; Staining and Labeling ; Thiazoles ; Tuberculosis, Pulmonary/complications