Bronchiolitis Obliterans Organizing Pneumonia Induced by Minocycline

We report a case of bronchiolitis obliterans organizing pneumonia (BOOP) caused by minocycline (MINO). A 59- year-old man visited to our hospital because of flu-like symptoms. He had been treated with MINO for a few weeks for the skin eruption. The chest radiograph showed consolidations in both lung fields. He was admitted to our hospital for further examination. An elevation of lymphocyte percentage was seen in his bronchoalveolar lavage and a diagnosis of BOOP was confirmed by video-assisted thoracoscopic lung biopsy. The symptoms, laboratory and radiological findings gradually improved without steroid therapy. Although the lymphocyte stimulation test (LST) of peripheral blood for MINO was negative, a positive oral provocation test confirmed the role of MINO in the induction of BOOP

Juvenile Idiopathic Nonspecific Interstitial Pneumonia. and Review of Literature

We describe a case of juvenile idiopathic nonspecific interstitial pneumonia (NSIP). This is the first report of a Japanese patient with idiopathic NSIP aged 27 years. A computed tomographic scan of the chest showed groundglass opacities and reticular opacities in subpleural distribution. Bronchoalveolar lavage fluid revealed no specific finding except for decreased CD4/CD8 ratio of lymphocyte subset. Histopathological features on examination of thoracoscopic lung biopsy specimens were consistent with those of NSIP group III. The patient was treated with corticosteroids and immunosuppressants, but no clinical improvement was noted and the general condition has gradually worsened. Although the prognosis is generally considered to be good in patients with NSIP, some patients die as a result of progression of the disease. The prediction of prognosis based on histopathological, radiologic, and bronchoalveolar lavage cell findings in NSIP seems to be difficult at present

Respiratory Bronchiolitis-associated Interstitial Lung Disease

We report a case of respiratory bronchiolitis-associated interstitial lung disease (RB-ILD). A 57-year-old man with a 74-pack-year smoking history, had cough, stridor, yellow purulent sputum and general fatigue for several days. The symptoms almost improved after treatment. However, chest computed tomography (CT) showed diffuse centrilobular ground glass opacities although the chest X-ray film showed no obvious opacities. Examination of bronchoalveolar lavage fluid showed relative lymphocytosis. Examination of lung biopsy obtained by video-assisted thoracoscopy allowed the diagnosis of RBILD. The opacities on the CT scan were improved spontaneously without any treatment after cessation of smoking

Effects of doxycycline on production of growth factors and matrix metalloproteinases in pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is characterized by progressive fibrosis and a poor prognosis. Alveolar epithelial cells (AECs) are considered to play important roles by releasing growth factors and matrix metalloproteinases (MMPs) and by being involved in epithelial mesenchymal transition in IPF. Doxycycline hydrochloride (DOXY), an inhibitor of MMPs, attenuates pulmonary fibrosis in models and in patients with IPF; however, the mechanism of this action remains obscure

Bronchiolitis Obliterans Organizing Pneumonia Induced by Minocycline

We report a case of bronchiolitis obliterans organizing pneumonia (BOOP) caused by minocycline (MINO). A 59- year-old man visited to our hospital because of flu-like symptoms. He had been treated with MINO for a few weeks for the skin eruption. The chest radiograph showed consolidations in both lung fields. He was admitted to our hospital for further examination. An elevation of lymphocyte percentage was seen in his bronchoalveolar lavage and a diagnosis of BOOP was confirmed by video-assisted thoracoscopic lung biopsy. The symptoms, laboratory and radiological findings gradually improved without steroid therapy. Although the lymphocyte stimulation test (LST) of peripheral blood for MINO was negative, a positive oral provocation test confirmed the role of MINO in the induction of BOOP

Effect of Erythromycin on Chronic Respiratory Infection Caused by Pseudomonas aeruginosa with Biofilm Formation in an Experimental Murine Model

Diffuse panbronchiolitis (DPB) is a chronic lower respiratory tract infection commonly associated with persistent late-stage Pseudomonas aeruginosa infection. However, low-dose long-term therapy with certain macrolides is effective in most patients with DPB. The present study was designed to examine the effects of long-term erythromycin (ERY) therapy by using our established murine model of chronic respiratory P. aeruginosa infection. ERY or saline was administered from day 80 after intubation with a P. aeruginosa-precoated tube for the subsequent 10, 20, 40, and 80 days. Bacteriologic and histologic analyses of the murine lungs and electron microscopy of the intubated tube were performed. In the murine model, treatment with ERY for 80 days significantly reduced the number of viable P. aeruginosa organisms in the lungs (P < 0.05). The biofilm formed in situ by P. aeruginosa on the inner wall of the inoculation tube placed into the murine bronchus became significantly thinner after 80 days of ERY treatment. We conclude that the clinical efficacy of macrolides in DPB may be due at least in part to the reduction in P. aeruginosa biofilm formation