Immunoglobulin G4-related lung disease presenting with a mediastinal mass

Immunoglobulin G4-related disease (IgG4-RD) is a recently identified systemic disease characterized by increased IgG4 level in serum and plasma cell infiltration resulting in “storiform fibrosis”. Although lung involvement is rare, clinical presentation is highly variable, including mediastinal lymphadenopathy, interstitial pneumonia, and pleural effusion. Glucocorticoid therapy is accepted as the mainstay treatment in IgG4-RD. Here, we present an IgG4-related lung disease (IgG4-RLD) case who was admitted to the hospital with chest pain; found out to have a mediastinal mass. IgG4-RLD was diagnosed based on histopathological features and a high blood IgG4 level. The patient’s steroid therapy was effective and there were no steroid-related side effects

The role of GSTM1 gene polymorphisms in lung cancer development in Turkish population

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DR-70: A promising biomarker for the detection of lung cancer

Objective: Lung cancer (LC) is characterized by an aggressive phenotype with a high mortality rate, early metastasis, and proliferation rate. Treatment options and prognosis differ significantly at each stage. Despite the availability of multiple imaging studies and invasive procedures, the disorder is diagnosed at an advanced stage. Therefore, it is essential to find biomarkers for the early detection of LC. Patients and Methods: Between 2018 and 2020, 73 LC and 71 control with the same demographic characteristics were included in our study. DR-70 level was measured by a photometric method in serum samples taken from all subjects. Results: A total of 144 subjects (110 male, 34 female) was included in the study. DR-70 levels in the LC group (2.53 +/- 2.64 mu g/mL) were found to be statistically significantly higher than the control group (0.56 +/- 1.23 mu g/mL). Clinical sensitivity and specificity of DR-70 for LC were found to be 87.67% and 88.73%. Conclusions: The high sensitivity and specificity of DR-70 can be used as a biomarker for rapid diagnosis in patients with LC. Compared with other tumor biomarkers, DR-70 seems to have a better sensitivity and specificity in the diagnosis of LC

Ruptura intrabronquial de un aneurisma de arteria pulmonar en un paciente con enfermedad de behçet

A 54-year-old man diagnosed with Behc ̧ et’s Disease (BD) 5 yearspreviously at another hospital was admitted to our center withmassive hemoptysis. The chest X-ray showed bilobular, smoothedged opacity localized in the left hilar and paracardiac regionthat not conceal heart contours (Fig. 1a, arrow)

Predictive value of the tuberculin skin test and QuantiFERON-tuberculosis Gold In-Tube test for development of active tuberculosis in hemodialysis patients

Background: Hemodialysis (HD) patients are at increased risk of reactivation of latent tuberculosis infection (LTBI) compared with the general population. QuantiFERON-TB Gold (QFT-G) for LTBI detection is more promising than tuberculin skin test (TST) in HD patients. AIM: In our study, we evaluated the value of the TST and QFT-G In-Tube (QFG-IT) test in the development of active tuberculosis (TB), in the HD patients, and in healthy controls. Methods: The study enrolled 95 HD patients and ninety age-matched, healthy controls. The TST and QFG-IT were performed. All the subjects were followed up 5 years for active TB disease. Results: Compared to the healthy controls, a high prevalence of LTBI was found in the HD patients by QFG-IT (41% vs. 25%). However, no significant difference was detected by TST (32% vs. 31%). Four HD patients and one healthy control progressed to active TB disease within the 5-year follow-up. For active TB discovered subjects, QFG-IT was positive in all, but TST was positive in two (one patient and one healthy control). In HD patients; sensitivity, specificity, positive and negative predictive values of QFG-IT, and TST for active TB was 100% and 25%, 62% and 67%, 10%, and 3%, and 100% and 95%, respectively. Receiver operating curve analysis revealed that the results are significantly different (P = 0.04). Conclusion: QFG-IT test is a more useful diagnostic method than TST for detecting those who will progress to active TB in HD patients

Endobronşiyal lipomun bronkoskopik tedavisi: Olgu sunumu

WOS: 000385271000027Endobronchial lipomas are very rare tumors. Although surgery may be required in some cases, bronchoscopic removal is the preferred treatment modality. In this article, we present a case of endobronchial lipoma incidentally found after excision of a giant esophagus diverticulum. During follow-up of the patient, a tumor, located in the right lower lobe bronchus, was seen at thorax computed tomography. The tumor was excised via rigid bronchoscopy. This case highlights the effectiveness of rigid bronchoscopy in the management of endobronchial tumors.Endobronşiyal lipomlar çok nadir tümörlerdir. Bazı olgularda cerrahi gereksinimi olabilse de bronkoskopik çıkarma tercih edilen tedavi yöntemidir. Bu yazıda, dev bir özofagus divertikülünün eksizyonu sonrası tesadüfen saptanan bir endobronşiyal lipom olgusu sunuldu. Hastanın takibinde, toraks bilgisayarlı tomografide sağ alt lob bronşunda yerleşik bir tümör görüldü. Tümör, rijit bronkoskopi yoluyla eksize edildi. Bu olgu endobronşiyal tümörlerin tedavisinde rijit bronkoskopinin etkinliğini vurgulamaktadır

Diagnosing latent tuberculosis in immunocompromised patients measuring blood IP-10 production capacity: An analysis of chronic renal faulire patients

WOS: 000451979404061Objective Patients undergoing haemodialysis for chronic renal failure-hemodialysis (CRF-HD) are at risk of latent tuberculosis infection (LTBI). The effectiveness of using blood IP-10 production capacity to diagnose LTBI in CRF-HD patients was analysed. Methods The study enrolled 50 CRF-HD patients. Interferon-γ release assay (IGRA) was done using QuantiFERON-TB Gold In Tube (QFG-IT) system. Blood IP-10 production capacity was measured using the QFG-IT system tubes. Tuberculin skin testing (TST) was performed on the same day and the test results were compared. Results TST turned out to be positive in 36.4% of the patients and QFG-IT in 54% of them. After stimulation with specific tuberculosis antigens, blood IP-10 levels increased noticeably. The antigen-stimulated blood IP-10 level was significantly higher in patients who were either TST or QFG-IT positive than in patients whose tests were negative (p=0.0001). Using 4.02 pg/mL as the threshold for stimulated blood logtransformed IP-10 level, good agreement was observed between IP-10 and QFG-IT results (κ=1). Conclusion Blood IP-10 level, which can be measured simply, provides results equivalent to IGRAs for the diagnosis of LTBI in CRF-HD patients

Amplitud de distribución eritrocitaria en pacientes con enfermedad pulmonar obstructiva crónica y en sujetos sanos

Background Chronic obstructive pulmonary disease (COPD) increases the risk of cardiovascular disease (CVD). Red blood cell distribution width (RDW) is accepted as a powerful predictor of outcomes in patients with CVD. Aims To study RDW in patients with COPD, and to compare the value of this measurement with clinical, echocardiographic, nutritional and laboratory status. Secondly, we aimed to determine the effect of smoking on RDW values in healthy subjects. Methods One hundred and seventy-five patients with stable COPD and 210 healthy controls were enrolled in the study. Demographic, clinical, nutritional status, echocardiographic, and laboratory characteristics, RDW values were recorded and compared. Results RDW values were higher in the COPD group than in controls (15±2.3% vs 13.8±2.5%, p<0.001). In COPD patients, RDW levels positively correlated with CRP levels (r=0.27, p<.001), albumin levels (r=0.23, P=.04), right ventricular dysfunction (RVD) (r=0.24, P=.001), pulmonary hypertension (PAH) (r=0.1, P=.02), and presence of CVD (r=0.24, P=.02). In multivariable logistic regression suggested that presence of CVD (4.3; 95% CI: 1.3–11; P=.01), and presence of RVD (3.1; 95% CI: 1.7–8.3; P=.02) were independently related to elevated RDW levels in COPD patients. In the healthy population, correlations analysis showed only a significant correlation between RDW and cigarette smoking years (r=0.57, p<.001). Conclusion RDW is independently associated with CVD and RVD in patients with COPD. In the healthy population, RDW is also associated with smoking status

Are soluble IL-2 receptor and IL-12p40 levels useful markers for diagnosis of tuberculous pleurisy?

WOS: 000350052900006PubMed ID: 25549699Background: The differential diagnostic utilities of the levels of soluble interleukin (IL)-12p40 and the IL-2 receptor in sera and pleural effusions were evaluated in patients with exudative pleural effusions. Methods: We enrolled a total of 120 patients with exudative pleural effusions. The clinical, radiological, and histopathological diagnoses were tuberculous pleurisy in 52, malignant pleurisy in 39, and parapneumonic effusions in 29 patients. Results: We measured serum IL-12p40 and adenosine deaminase (ADA) levels in patients with tuberculous pleurisy and in a control group treated for pleural effusion to determine if such levels were useful in the diagnosis of pleural effusion (p < 0.005). Definite microbiological or histopathological diagnoses of tuberculous pleurisy or pleural effusion were recorded, and we found that ADA and serum soluble IL-2 receptor levels aided in diagnosis (p < 0.001). The levels of ADA and soluble IL-2 in pleural effusions afforded sensitivities and specificities of 84.62% and 82.69% and of 70.59% and 80.88%, respectively. The soluble IL-2 receptor level afforded a sensitivity and specificity of 82.69% and 52.9%. IL-12p40 levels in pleural effusions and sera afforded sensitivities and specifi cities of 80.77% and 80.77% and of 60.29% and 39.71%, respectively. Conclusion: Soluble IL-2 receptor levels in patients with tuberculous pleurisy serve as markers of disease in non-endemic countries, similarly to ADA levels

Endobronchial management of an endobronchial hamartoma

Endobronchial hamartoma (EH) is a rare benign tumor of the bronchial tree. This tumor can obstruct the bronchus or cause bleeding. The treatment method is chosen according to location and extent of the tumor. Endobronchial hamartoma can be resected via bronchoscopic approach; surgical therapy, is alternative only for cases where the tumor cannot be resected completely through endoscopy, or if irreversible pulmonary changes secondary to obstruction of the bronchus occurred. We herein describe a 52-year-old female presented with progressive dyspnea and treated with diagnosis of asthma. In this patient, EH which is located in the left main lobe bronchus was found in radiologic assement. Bronchoscopy revealed a broad-based mass obstructing the bronchus. The tumor was resected after coagulation of the tumor with argon plasma coagulation, by the rigid bronchoscope. Pathologic diagnosis was reported as EH. This report highlights the success of rigid bronchoscopic approach in the management of EH