Search PubMed⌕ Search

Biomedical subjects

B Wallaert

Publications and source records attributed to B Wallaert.

At least 271 records · Page 15Linked to original sources
PubMed1986

Activated alveolar macrophage and lymphocyte alveolitis in extrathoracic sarcoidosis without radiological mediastinopulmonary involvement.

Cellular characteristics of BAL were investigated in 18 patients with proved extrathoracic sarcoidosis (that is, sarcoidosis that affected the skin, eyes, parotid glands, stomach, nose, kidneys, or meninges) without clinical or radiological mediastinopulmonary involvement. Computed tomography of the thorax was performed on five patients: four patients were normal, and one had enlarged lymph nodes (these enlargements were not detectable on the patient's chest roentgenogram). The results of pulmonary function tests were normal in all patients. The total BAL cell count did not differ significantly between controls and patients. Abnormal percentages of alveolar lymphocytes (from 18 to 87%) were noted in 15 out of 18 patients. SACE levels were normal in 15 patients. No pulmonary gallium uptake was detected. The chemiluminescence of AM's, whether spontaneous or PMA induced, was increased in five out of seven patients. The percentages of T3+ lymphocytes in sarcoidosis patients did not significantly differ from those in controls. The T4+:T8+ ratio was normal in four patients and slightly increased in one. Follow-up of patients showed that alveolar lymphocytosis is as lasting as extrathoracic involvement. Our data demonstrate increased percentages of lymphocytes and activated AM's in the BAL of patients with extrathoracic sarcoidosis. This may be due to the initial involvement of the respiratory tract in extrathoracic sarcoidosis or to the diffusion of activated macrophages and lymphocytes from an extrathoracic site into the lung.

Adult↗
PubMed1986

Latent pulmonary involvement in Crohn's disease: biological, functional, bronchoalveolar lavage and scintigraphic studies.

We have investigated the following pulmonary related parameters in 22 patients with Crohn's disease who were free of clinical pulmonary symptoms and had normal chest roentgenograms and in 25 controls: serum angiotensin converting enzyme, pulmonary function tests, bronchoalveolar lavage (lymphocyte count and subpopulations, macrophage viability and superoxide anion release by macrophages) and pulmonary scannings. Serum angiotensin converting enzyme was lower in Crohn's disease (14.1 +/- 5.1) than in controls (25.2 +/- 4.7) (p less than 0.001). Twelve of 22 Crohn's disease (54%) had a bronchoalveolar lavage lymphocytosis (greater than 18% alveolar lymphocytes). Bronchoalveolar lavage lymphocytes subpopulations were quite variable. Twelve of 17 Crohn's disease (71%) had an increase spontaneous and/or stimulated superoxide anion production by alveolar macrophages. Six of 12 Crohn's disease (50%) had an increase physiologic dead space in the upper part of their lung against one of 11 controls (9%). These data suggest that most patients with Crohn's disease have a latent pulmonary involvement.

Adolescent↗
PubMed1986

Subclinical pulmonary involvement in collagen-vascular diseases assessed by bronchoalveolar lavage. Relationship between alveolitis and subsequent changes in lung function.

Collagen-vascular disorders (CVD) are commonly associated with chronic interstitial lung disease. Clinicopathologic observations suggest that inflammatory process of the lower respiratory tract may appear prior to fibrosis. Subclinical pulmonary involvement, as assessed by bronchoalveolar lavage (BAL) was evaluated in 61 patients with various CVD but free of clinical pulmonary symptoms and with normal chest roentgenograms. Eight of 61 had abnormal pulmonary function tests (PFT) at entry to the study. Total BAL cell yield from nonsmokers was greater in patients with abnormal than in those with normal PFT (p less than 0.05). Abnormal differential count of BAL cells was noted in 29 of 61 patients (48%). Lymphocyte alveolitis (lymphocytes greater than or equal to 18%) was a characteristic finding in patients with primary Sjögren's syndrome (11 of 25) or Sjögren's syndrome associated with another CVD (4 of 8). Neutrophil alveolitis (neutrophils greater than 4%) with or without increased percentage of lymphocytes occurred in patients with CVD classically associated with pulmonary fibrosis: progressive systemic sclerosis (6 of 10), rheumatoid arthritis (1 of 4), dermatopolymyositis (2 of 3), and mixed connective tissue disease (3 of 8). An increased percentage of eosinophils was detected in 1 patient with progressive systemic sclerosis. Bronchoalveolar lavage abnormalities were more frequently detected in patients with active and severe extrapulmonary disease. On follow-up PFT 12 months later, 11 patients with normal BAL and 10 patients with lymphocyte alveolitis had not deteriorated. In marked contrast, the presence of neutrophils in BAL was associated with a progressive deterioration of PFT in 6 of 7 untreated patients, whereas 4 corticosteroid-treated patients with neutrophil alveolitis had not deteriorated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Primary biliary cirrhosis. Subclinical inflammatory alveolitis in patients with normal chest roentgenograms.

To determine whether a subclinical inflammatory alveolitis is associated with primary biliary cirrhosis (PBC), we compared the numbers and types of cells recovered by bronchoalveolar lavage from 12 patients with PBC, ten healthy control subjects, and nine patients with alcoholic cirrhosis (AC). All were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. Total BAL cell count did not differ among patients with PBC (mean 9.6 X 10(4) cells/ml), patients with AC (mean 14.8 X 10(4) cells/ml), and control subjects (mean 9.9 X 10(4) cells/ml). Patients with PBC but not patients with AC had an increased proportion of lymphocytes in bronchoalveolar lavage fluid (respectively 22.4 percent +/- 5.2 and 11.6 percent +/- 2.52 compared with the normal value of 9.9 percent +/- 1.5 p less than 0.05). In the same way, alveolar lymphocytosis of the lower respiratory tract from PBC patients predominantly comprised T4+ (helper/inducer) T-lymphocyte subset in patients showing an increased alveolar lymphocytosis. Alveolar macrophages from PBC patients showed a dramatic increased chemiluminescence response before and after stimulation by phorbol-myristate-acetate, regardless of the intensity of alveolar lymphocytosis. Thus, our data demonstrated that subclinical alveolar inflammation comprising T-lymphocytes and activated alveolar macrophages mimicking sarcoid alveolitis is present in a high proportion of patients with PBC.

Adult↗
PubMed1986

[Value of x-ray computed tomography in assessing the extent of invasive lympho-epithelial thymoma in the adult. Therapeutic implications].

This study concerns 12 patients who were in hospital for the work-up and treatment of an invasive lympho-epithelial thymoma. The extent of the disease was studied by systemic computed tomographic (CT) scanning of the thorax and abdomen. Three patients out of nine examined presented initially with asymptomatic renal metastasis. Three patients were treated straight away by poly-chemotherapy; the nine others benefitted either from radiotherapy alone (four cases) or from radiotherapy associated with surgery (4 cases) or an isolated surgical exploration (1 case). CT examination was carried out in 11 patients 3 months after the beginning of treatment and 7 times clinically latent metastasis were rediscovered (renal, adrenal, hepatic, thyroid, cerebral and osseous). These 11 patients benefitted secondarily from polychemotherapy. The results confirm the gravity of the condition: only three patients are living and in complete remission with a follow up of 24 to 48 months. The frequency of latent metastasis, detected by CT scanning, during the course of a malignant thymoma justifies the systematic performance of this examination in the work up of the disease extent and therapeutic surveillance in these patients, and leads one to reconsider the place of chemotherapy in the therapeutic strategy of these tumours.

Adrenal Cortex Neoplasms↗
PubMed1986

[Mechanisms of allergic asthma].

The patho-physiology of allergic asthma is the result of several closely interrelated mechanisms. The hypersensitivity to mediation by IgE implies mast cell intervention and also by other non-mast cells possessing a receptor for Fc fragments of IgE. Their activation leads to the liberation of numerous mediators, some of which act directly on the bronchial smooth muscle fibres whilst others intervene by "pro-inflammatory effects". The other essential compound of asthma is non specific bronchial hyperreactivity. In reality the two phenomena are closely linked as is shown with changes in bronchial hyperreactivity after exposure or the inverse, by elimination of the allergen. The slow reaction linked to IgE by the cellular influx which it provokes in the airways amplifies the local inflammatory reaction and by this interacts with the autonomic nervous system.

Adrenal Cortex Hormones↗
PubMed1986

High-dose methylprednisolone pulse therapy in sarcoidosis.

Intravenous methylprednisolone in "pulse" dose (30 mg/kg, once a week for 6 weeks) with or without oral maintenance corticosteroid therapy was administered to 12 patients with chronic sarcoidosis. Disease activity was evaluated by broncho-alveolar lavage, serum angiotensin converting enzyme assay and 67Ga scanning. Efficacy was assessed by clinical, radiological, and functional data. Pulse methylprednisolone produced immediate improvement in all patients but eight of the 12 patients relapsed 1 year later; one patient without maintenance corticosteroids and three patients with maintenance oral corticosteroids showed persistent improvement. However, there was no significant difference in criteria of disease activity of each patient before pulse therapy and 1 year later (p greater than 0.5). In conclusion, high dose therapy has immediate but transient effects whether or not it is supplemented by conventional corticosteroid therapy at the lower maintenance dosage.

Adult↗
PubMed1986

[An unusual cause of right-left shunt: anastomosis of the left superior vena cava with the left atrium].

We report the case of a 73 year old man presenting with severe hypoxaemia due to an anatomical right to left shunt from a persistent left superior vena cava (VCSG) anastomosing with the left auricle. This was fortuitously discovered while placing a left sub clavicular catheter; the diagnosis of the VCSG draining into the left auricle was confirmed by superior phlebography and CT scanning. The discovery of this shunt after a pulmonary embolus suggested to us that the rise in venous pressure secondary to the embolus led to both clinical symptoms and hypoxaemia from the shunt, which had until then been clinically silent. No surgical treatment was performed.

Aged↗
PubMed1986

[Subacute pneumopathy caused by hydrochlorothiazide. Cytologic study of the broncho-alveolar lavage].

We report a case of diffuse interstitial pulmonary disease in a 73 year old woman treated for moderate hypertension for one year with the combination of hydrochlorothiazide (50 mg/day) and Amiloride (5 mg/day). The bronchoalveolar lavage showed a neutrophilia of 23% and a 5.5% eosinophilia. The absence of any other aetiological factor and the favourable outcome on cessation of the sole medication incriminate the latter as an aetiological agent in this interstitial pneumonitis.

Aged↗
PubMed1986

[Opportunistic pneumopathy caused by Torulopsis glabrata].

Yeasts are taking a growing place in the development of opportunistic pneumonias in a hospital environment. We report a case of pneumonia due to Torulopsis glabrata in a patient of 58 years in complete remission from a malignant oesophageal tumour after surgery and radiotherapy, and not given immunosuppressive treatment.

Candidiasis↗
PubMed1986

Eosinophilic lung disease: immunological studies of blood and alveolar eosinophils.

Five patients with eosinophilic lung diseases and blood hypereosinophilia (PIE syndrome) were investigated clinically and by bronchoalveolar lavage (BAL). Comparative studies on blood and alveolar eosinophils were carried out after purification and selection of eosinophil subpopulations according to their density. A predominant 'hypodense' alveolar eosinophil population was found in BAL fluids of active chronic eosinophilic pneumonia (CEP). In addition, supernatants of alveolar macrophages obtained from CEP are able to enhance spontaneously the generation of eosinophil oxygen metabolites. Such eosinophil stimulation emphasizes a probable tissue cell cooperation. In addition, BAL permitted the study of membrane immunological markers on eosinophilic inflammatory cells endowed with migratory properties. An increase in eosinophils carrying surface IgE was demonstrated in alveolar cells from PIE Syndrome particularly with hypodense eosinophils from CEP patients. Although no specific stimulus is known at the present time, this work underlines the potential implication of IgE-mediated hypersensitivity processes in the pathogenesis of eosinophilic lung diseases.

Adult↗
PubMed1985

[Dermatopolymyositis and pulmonary fibrosis associated with Gougerot-Sjogren syndrome. Study of 3 cases].

3 new cases of dermatomyositis associated with diffuse interstitial pulmonary fibrosis and, more exceptionally, with Sjögren's syndrome are reported. The pulmonary fibrosis observed in patients with dermatomyositis differs from that found in other connective tissue diseases in that it follows a more acute course and may respond to corticosteroids. Thus, in 2 of these patients treated with corticosteroids (combined in 1 case with cyclophosphamide) the high percentage of lymphocytes and polymorphonuclears in the broncho-alveolar lavage fluid, which reflects alveolitis activity, was reduced and the pulmonary fibrosis was cured in one patient and stabilized in the other.

Cyclophosphamide↗
PubMed1985

[Renal insufficiency caused by chronic granulomatous interstitial nephritis in Löfgren's syndrome].

The authors report the case of a woman with Löfgren's syndrome who developed renal failure associated with abnormalities of acidification and concentration of the urine. In the absence of a phosphate-calcium metabolic disturbance, these signs were attributed to a granulomatous interstitial nephropathy demonstrated on renal biopsy. These abnormalities regressed completely with steroid therapy. Secondary renal failure due to an isolated granulomatous interstitial nephropathy is exceptionally rare in sarcoidosis and has never been previously reported in Löfgren's syndrome.

Acute Kidney Injury↗
PubMed1985

Aspirin-sensitive asthma: abnormal platelet response to drugs inducing asthmatic attacks. Diagnostic and physiopathological implications.

The pathogenesis of aspirin-sensitive asthma remains unknown. Using a new model of platelet activation, initially described as a response of platelets to IgE antibody-dependent stimuli, this study was designed to test the hypothesis of a possible involvement of platelets in aspirin-sensitive asthma. Washed platelets from 35 aspirin-sensitive asthmatics showed an abnormal in vitro response to cyclooxygenase inhibiting nonsteroidal anti-inflammatory drugs (NSAIDs)--aspirin, indomethacin or flurbiprofen--characterized by the generation of a cytocidal supernatant and (14 patients explored) a burst of chemiluminescence; these drugs had no similar effect on platelets from 31 controls (p less than 0.0001). It was shown that the abnormal platelet response to NSAIDs was not mediated by IgE. In contrast to platelets, aspirin-sensitive asthmatic leukocytes generated neither cytocidal factors nor chemiluminescence in the presence of NSAIDs. Sodium salicylate and salicylamide, which, though structurally similar to aspirin, do not inhibit cyclooxygenase and are well tolerated by aspirin-sensitive asthmatics, did not activate their platelets to release cytocidal factors. Moreover, preincubation of platelets with sodium salicylate, salicylamide or prostaglandin endoperoxide PGH2, highly prevented their abnormal response to NSAIDs (greater than 80%; p less than 0.0001). Since several lipoxygenase inhibitors (NDGA, esculetin), including inhibitors of both cyclooxygenase and lipoxygenase (ETYA, BW755c), did not activate patient platelets and prevented the subsequent abnormal response to NSAIDs, it is suggested that the abnormal platelet activation by NSAIDs is not only the consequence of an inhibition of cyclooxygenase, but also involves generation of lipoxygenase metabolites of arachidonate. Besides, platelets from 4 aspirin-sensitive asthmatics undergoing aspirin desensitization were found to have completely lost their abnormal responsiveness to NSAIDs. These findings represent the first identification in aspirin-intolerant asthmatics of a specific abnormal cellular response to drugs inducing asthmatic attacks and open new perspectives into the pathogenesis, prevention and diagnosis of this disease. They also provide support to the concept of a role for platelets in asthma.

Adult↗