• Tuberculosis and Respiratory Diseases
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• v.78 no.2
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• pp.133-136
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• 2015

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitive disease showing various radiographic and clinical manifestations. Its clinical course has not been fully understood. Here I describe a case of a 23-year-old immunocompetent man with frequently relapsing ABPA. He was asthmatic. He visited our hospital because of a chronic cough. Laboratory examination showed eosinophilia with increased total and Aspergillus-specific IgE as well as positive skin reaction to Aspergillus fumigatus. Radiologic feature was a dense consolidation. Histology showed organizing pneumonia with eosinophilic infiltration. On the diagnosis of ABPA, he was treated with systemic steroid and itraconazole. Although treatment response was excellent, he suffered from recurrent ABPA three times thereafter in the form of fleeting mass-like consolidation.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.65-74
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• 1999

Background : Open lung biopsy(OLB) has conventionally been regarded as the gold standard for the diagnosis in interstitial lung disease. With recent advances in diagnostic technique such as high resolution computed tomography(HRCT), and transbronchial lung biopsy(TBLB) which provide relatively accurate diagnosis of ILD, it is necessary to reevaluate the role of these methods in the diagnosis of ILD. Methods: We carried out a retrospective analysis of nineteen patients who underwent OLB at Dankook University Hospital for the diagnosis of acute and chronic ILD, between May 1995 and June 1998. By reviewing the medical records, the demographic findings, underlying conditions, HRCT and TBLB findings, OLB diagnosis, therapy after OLB, and complication of OLB were evaluated. Results: Thirteen patients(68.4%) had chronic ILD(symptom duration over 2 weeks prior to OLB), and six patients(31.6%) had acute ILD(symptom duration less than 2 weeks). Specific diagnosis were reached in 92%(12/13) of chronic ILD(5 bronchiolitis obliterans organizing pneumonia(BOOP), 2 constrictive bronchiolitis, 3 usual interstitial pneumonia, 1 hypersensitivity pneumonitis, 1 eosinophilic pneumonia), and in all patients of acute ILD(5 acute interstitial pneumonia, 1 pneumocystis carinii pneumonia). HRCT were performed in all patients and a correct first choice diagnosis rate of HRCT was 42%(5/12) in chronic ILD. In chronic ILD patients, 62%(8/13) received specific therapy(steroid therapy in 7 patients and moving in one patient), after OLB, but in acute ILD, all patients received specific therapy(steroid therapy in 5 patients and steroid and antibiotic therapy in one patient) after OLB. The in-hospital mortality after OLB was 5.3%(1/19). Conclusion: OLB is an excellent diagnostic technique with relatively low complications in patients with ILD. Therefore OLB should be considered in patients with ILD when the specific diagnosis is important for the treatment, especially in patients with acute ILD.

• Tuberculosis and Respiratory Diseases
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• v.71 no.6
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• pp.459-463
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• 2011

Pulmonary complications occur in 40~60% of patients who receive hematopoietic stem cell transplantation (HSCT) and are a source of substantial morbidity and mortality. Acute eosinophilic pneumonia (AEP) is an uncommon, non-infectious pulmonary complication occurring in HSCT recipients. We now report the case of a 52-year-old man with AEP who was treated with allogenic HSCT due to acute myeloid leukemia. He complained of fever, cough and dyspnea 390 days after allogenic HSCT. He also had skin and hepatic graft versus host disease (GVHD). Hypoxemia, diffuse pulmonary infiltrates on a chest x-ray and eosinophilia in bronchoalveolar lavage fluid were also noted in several tests. His symptoms, pulmonary infiltrates, hepatic dysfunction and skin lesions rapidly improved after treatment with corticosteroid therapy. Our case supports the idea that AEP is a late phase non-infectious pulmonary complication and one of the manifestations of chronic GVHD.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.426-433
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• 2010

Background: Persistent cough has recently been found to be associated with Chlamydia pneumoniae infection. We aimed to investigate the infection rate of C. pneumonia in adult patients with chronic cough. Methods: We recruited 68 patients with persistent cough lasting in excess of 3 weeks, who visited Kangdong Sacred Heart Hospital from January 2005 to August 2005. On the first visit, chest and paranasal sinuses radiography, skin prick test of common allergens, and induced sputum samples for C. pneumoniae were performed in all of patients. Further evaluation for diagnosis included a methacholine provocation test and eosinophil counts in induced sputum. Results: The most common cause of chronic cough was upper airway cough syndrome (UACS) (26.5%), followed by eosinophilic bronchitis (20.6%) and cough variant asthma (16.2%). Idiopathic chronic cough was the cause in 33.8% of patients. The mean duration of cough was 11.7 months. C. pneumoniae was isolated by polymerase chain reaction (PCR) from one patient who had upper respiratory air way syndrome. Conclusion: Chlamydia pneumoniae appears to have a minor role as a cause of chronic cough in patients.