Two cases of serious hepatic injury caused by antithyroid drugs

W pracy przedstawiono dwa przypadki istotnego uszkodzenia wątroby spowodowanego przez tyreostatyki u kobiet z chorobą Gravesa- Basedowa leczonych z powodu nietolerancji kolejno metimazolem i propylotiouracylem. Dominującym objawem była żółtaczka trwająca ogółem około 3 miesięcy. W leczeniu poza odstawieniem tyreostatyków stosowano prednison oraz kwas ursodezoksycholowy. Pozytywny wpływ na przebieg choroby miała także likwidacja tyreotoksykozy po podaniu 131I. W podsumowaniu podkreślono znaczenie szybkiego odstawienia tyreostatyku w momencie wystąpienia istotnych objawów toksycznych oraz zaniechanie próby zamiany tyreostatyku na inny na rzecz leczenia radiojodem.We present two cases of severe hepatotoxicity caused by antithyroid drugs in women with Graves disease. The first medication in both cases was methimazole replaced by propylhiouracil due to intolerance. The main symptom was jaundice lasting about 2 months. As a first step in the treatment we terminated the antithyroid drug administration and introduced prednisone and ursodesoksycholic acid therapy. The termination of thyrotoxicosis by means of 131 I administration had also positive influence on the course of disease. In summary we emphasise the significance of prompt discontinuation of antithyroid drug once toxic symptoms appeared and avoid replacement one thyrostatic drug for another in fovour of radioiodine treatment

A case report of allergic bronchopulmonary aspergillosis - disease well known but rarely diagnosed

Allergic bronchopulmonary aspergillosis (ABPA) is a consequence of hypersensitivity reaction to Aspergillus fumigatus that can chronically colonize the air ways of patients with abnormalities in their airway mucosal defenses, including mucociliary clearance and epithelial cell function, such as patients with bronchial asthma and cystic fibrosis. We present an interesting case of a 62-year-old woman who presented with purulent cough, subfebrile temperature and chest pain. She was ineffectively treated for a month with standard antibiotics and was finally diagnosed with ABPA

Cutaneous recurrence of long term pulmonary sarcoidosis - literature review and case report

Sarcoidosis is a systemic granulomatous disease, the exact etiology of which is unknown. This paper presents a case of a patient with a long course of pulmonary sarcoidosis with exacerbation of the disease in the form of skin lesions.                A 50-year-old female patient was admitted to the Department of Tuberculosis and Lung Diseases, Medical University of Lublin, because of cervical lymphadenopathy. Based on the histopathological examination, she was diagnosed with sarcoidosis. The patient reported constant fatigue, throat tightness and difficulty swallowing, as well as decreased exercise tolerance. Computed tomography studies revealed small nodular changes in both lungs and mediastinal lymphadenopathy. The patient was actively monitored. The results of spirometry tests improved spontaneously and remained at a satisfactory level for years. After 15 years of follow-up, the patient reported skin lesions that are constantly progressing. Examination of the cut from the skin lesion confirmed skin sarcoidosis. This case report highlights the varied course of sarcoidosis, which, as a multi-system disease, may show various manifestations. In clinical practice, therefore, one should consider the possibility of disease progression and transmission to multiple organs. It is important that the patient is under constant observation and that new lesions undergo differential diagnosis and histopathological examination

Tracheopbronchopatia osteochondroplastica – a case presentation

Narrowing of the lower respiratory tract is a rare pathology. It may be associated with pathologies of the primary respiratory system or connective tissue diseases (systemic scleroderma, granulomatosis with polyangiitis, relapsing polychondritis). It can lead to non-specific clinical symptoms. We present an interesting case of a 52-year old patient with a history of several months’ dyspnea. Imaging tests revealed significant stenosis of the trachea and the left main bronchus. Tracheobronchopatia osteochondroplastica was diagnosed. Moreover, we carry out the differential diagnosis of the above pathology

Hiccup as an uncommon symptom of pneumonia

Terlecka Paulina, Grzywa Celińska Anna, Emeryk Maksymiuk Justyna, Szmygin Milanowska Katarzyna, Milanowski Janusz. Hiccup as an uncommon symptom of pneumonia. Journal of Education, Health and Sport. 2017;7(12):111-117. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1108599 http://ojs.ukw.edu.pl/index.php/johs/article/view/5108 https://pbn.nauka.gov.pl/sedno-webapp/works/840705 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.11.2017. Revised: 15.11.2017. Accepted: 12.12.2017. Hiccup as an uncommon symptom of pneumonia Paulina Terlecka1, Anna Grzywa-Celińska1, Justyna Emeryk-Maksymiuk2, Katarzyna Szmygin-Milanowska1, Janusz Milanowski1 1 - Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Poland 2 - Chair of Internal Medicine and Department of Internal Medicine in Nursing, Medical University of Lublin, Poland Corresponding author: Paulina Terlecka, MD Chair and Department of Pneumonology, Oncology and Allergology Medical University of Lublin 20-954 Lublin, Poland 8 Jaczewskiego St. phone number: +48817244431 fax number: +48817244823 e-mail: [email protected] Abstract Hiccup is a symptom resulting with uncontrolled contractions of the diaphragm and external intercostals muscles with inspiration and with simultaneous sudden closure of the glottis, that produces specific “hic” sound. Depending on the time of duration, hiccup can be classified as acute (up to 48h), chronic (48h to 1 month) and persistent (lasting longer than one month). The exact pathophysiology of this symptom still remains unknown, though it is well known, that short-term episodes of hiccup are mainly caused by oesophagus and stomach diseases (gastric and duodenal ulcers, gastritis, gastro-oesophageal reflux) or alcohol consumption. Other reasons of this phenomenon include the diseases with the stimulation of the vagus nerve or conditions with diaphragm irritation. It can be also psychogenic or resulting from central nervous system diseases. Short term episodes of hiccup happen to every person and do not cause any concern. Chronic hiccups can lead to significant worsening of quality of life including fatigue, nutritional restrictions, dehydration, weight loss, insomnia, respiratory disorders, depression or even suicidal thoughts. We present an interesting case with diagnostic and therapeutic procedures in a 65-year-old smoker, who was hospitalized in our Department because of pneumonia, with persistent hiccup as an additional complaint considerably deteriorating his quality of life. Key words: hiccup, symptom, pneumonia

Malignant peripheral nerve sheath tumor in a patient without neurofibromatosis 1 (NF1): a rare case of primary lung location

We present a rare case of a patient operated due to a lung tumor, which was ultimately diagnosed as malignant peripherial nerve sheath tumor (MPNST). MPNSTs are rare tumors of soft tissue with mesenchymal origin. The World Health Organization has distinguished this group in order to unify terms in mesenchymal heterogeneous malignant tumors, e.g. neurofibrosarcomas, malignant schwannomas and malignant neurilemmoma [1]. They can occur as a result of neoplastic expansion of peripheral nerves’ branches, peripheral nerve fibers’ sheaths or Schwann cells, although many researchers believe that these tumors can derive not only from one, but several cell lines. MPNSTs are very rare in thorax, where they show aggressive pattern of growth [2] and stem from pleural cells rather than lung tissue.   

Radon—The Element of Risk. The Impact of Radon Exposure on Human Health

Lung cancer is a heterogeneous group of diseases with multifactorial aetiology. Smoking has been undeniably recognized as the main aetiological factor in lung cancer, but it should be emphasized that it is not the only factor. It is worth noting that a number of nonsmokers also develop this disease. Radon exposure is the second greatest risk factor for lung cancer among smokers—after smoking—and the first one for nonsmokers. The knowledge about this element amongst specialist oncologists and pulmonologists seems to be very superficial. We discuss the impact of radon on human health, with particular emphasis on respiratory diseases, including lung cancer. A better understanding of the problem will increase the chance of reducing the impact of radon exposure on public health and may contribute to more effective prevention of a number of lung diseases

Ocena jakości badania spirometrycznego u osób powyżej 80. roku życia

Background. Spirometry is the gold standard in lung function assessment. Ventilation disturbances diagnoses are based on spirometry parameters. Good cooperation between technicians and patients is essential to get good quality records. The aim of the study was to qualify the control and to estimate the possibility to perform spirometry in the group of women and men aged 80 and more. Material and methods. The results of 45 patients, 27 male and 18 female, aged 80 and more years, examined in our lung function laboratory between 1994–2004, were assessed according to American Thoracic Society recommendations for spirometry. Results. Only 2 persons were unable to carry out spirometry at all. 30 (66%) patients were able to prolong expiration for 6 or more seconds. Forced expirations were acceptable in 50% of cases but the whole examinations were acceptable and repeatable in 5 cases (11%) according to American Thoracic Society quality criteria. Conclusions. In conclusion authors claim that even though the analysis proved difficulties in obtaining good quality results in elderly, spirometry should still be carried out for better diagnosis and correct treatment.Wstęp. Badanie spirometryczne jest standardem oceny czynności wentylacyjnej układu oddechowego i stanowi podstawę rozpoznawania zaburzeń wentylacji. Wykonanie spirometrii wymaga współpracy badającego i badanego. Jest to warunek konieczny do uzyskania spirogramu spełniającego określone kryteria jakości. Celem badania była ocena jakości i możliwości wykonywania badania spirometrycznego przez osoby w wieku co najmniej 80 lat. Materiał i metody. Oceny spirogramów dokonano na podstawie wytycznych American Thoracic Society opublikowanych w 1995 roku. Analizowano spirogramy osób w wieku co najmniej 80 lat, skierowanych w ciągu ostatnich 10 lat do Pracowni Badań Czynnościowych Płuc SPSK Nr 1 w Lublinie. Wyniki. U większości pacjentów uzyskano zapis badania spirometrycznego. Jedynie 2 chorych nie wykonało manewru natężonego wydechu, zaś 30 badanych (66%) uzyskało co najmniej 6-sekundowy czas trwania wydechu. Blisko połowa pacjentów wykonała zadowalający manewr natężonego wydechu, ale jedynie 11% chorych wykonało badanie spełniające wszystkie kryteria akceptowalności i powtarzalności. Wnioski. Analiza jakości badania spirometrycznego pacjentów w wieku 80 i więcej lat obiektywnie pokazała trudności w uzyskaniu zadowalającego, dobrego jakościowo badania spirometrycznego. Wydaje się jednak,że badanie takie, choć trudne do przeprowadzenia u starszych osób, powinno się wykonywać, aby postawić prawidłową diagnozę i skutecznie leczyć tych pacjentów