Schweres Asthma im Kindesalter und Bronchiektasen

2019 ◽  
Vol 7 (6) ◽  
pp. 329-330
Author(s):  
David Brandt
Keyword(s):  
Severe Asthma ◽  
Ct Images ◽  
Wall Thickening ◽  
Asthmatic Children ◽  
Cell Counts ◽  
Ct Findings ◽  
Single Centre Study ◽  
Serum Total Ige ◽  
Difficult Asthma ◽  
Schweres Asthma

Background: Chest computed tomography (CT) scans have a recognised role in investigating adults with severe asthma to exclude alternative diagnoses, but its role in children is less clear. The objective of this study was to review the CT findings of our local cohort of children with severe asthma and to explore whether clinical or pathobiological parameters predicted CT changes. Methods: Retrospective observational single centre study including all children attending the Leicester difficult asthma clinic (DAC) who underwent a chest CT from 2006 to 2011. Additionally, we recruited eight age-matched, non-asthmatic controls to compare differences in CT findings between asthmatic and non-asthmatic children. All CT images were independently scored by two radiologists. The DAC patients were sub-divided into binary groups for each abnormality identified so that comparisons could be made against recorded clinical variables including age, lung function, serum total IgE levels, and sputum leukocyte differential cell counts. Results: Thirty DAC patients (median 12 yrs., range 5-16) were included. The most common abnormalities were bronchial wall thickening (BWT) and air trapping (AT), observed in 80 and 60% of DAC patients. Bronchiectasis (BE) was identified in 27% of DAC patients. DAC patients with evidence of BE on CT images were older than those without BE (13.9 ± 0.67 vs 11.5 ± 0.61, p = 0.038). We also identified a positive correlation between increasing BE severity and extent with age (r = 0.400, p = 0.028). Conclusion: Abnormal CT findings were highly prevalent in our cohort of children with severe asthma, with bronchiectasis identified in approximately one third of children. We found no alternative diagnoses that resulted in a change in clinical management.

Helical CT Findings of Gastric Wall Thickening by Peptic Ulcer: Compared with Gastric Adenocarcinoma with Ulcer

2000 ◽  
Vol 42 (2) ◽  
pp. 281
Author(s):  
Won Jung Jung ◽  
Jong Chul Choi ◽  
Keum Soo Seo ◽  
Bon Sik Koo ◽  
Byeong Ho Park ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastric Adenocarcinoma ◽  
Gastric Wall ◽  
Helical Ct ◽  
Wall Thickening ◽  
Ct Findings

scholarly journals Common and Uncommon Imaging Appearances of COVID-19 Pneumonia in Young and Middle-Aged Group and Elderly Group

2021 ◽  
Author(s):  
Alireza Mahmoudabadi ◽  
Hamed Masoumi ◽  
Mohammad Keshtkar ◽  
Arash Azhideh ◽  
Hamidreza Haghighatkhah
Keyword(s):  
Pleural Effusion ◽  
Ground Glass Opacity ◽  
The Elderly ◽  
Ct Images ◽  
Elderly Group ◽  
Wall Thickening ◽  
Lung Region ◽  
Middle Aged ◽  
Aged Group ◽  
Lower Lung

Purpose: In this study, we retrospectively evaluated chest Computed Tomography (CT) imaging manifestations of the patients with Coronavirus Disease 2019 (COVID-19) to simplify prompt early diagnosis of disease and speed up needed actions for infected patients. Materials and Methods: Totally, 75 patients who laboratory confirmed COVID-19 pneumonia were enrolled in this study. CT images, demographic and some clinical data of all patients were collected and analyzed retrospectively. Furthermore, for comparison, the patients were divided into two groups as follows: the young and middle-aged group (< 60 years old) and the elderly group (≥ 60 years old). Results: Based on the evaluation of CT images, 33 patients (44%) showed Ground-Glass Opacity (GGO), 15 patients (20%) showed consolidation, 24 patients (32%) showed mixed GGO and consolidation, 2 patients (2.6%) had bronchial wall thickening, 10 patients (13.3%) had a crazy paving sign, 35 patients (46.6%) had air bronchogram and, 7 patients (9.3%) had cavitation and 2 patients (2.6%) had a tree in the bud. CT images of 3 patients (4%) were normal. In terms of out of lung changes, lymphadenopathy was observed in one patient (1.3%), pleural effusion in 12 patients (16%), and pericardial effusion in 2 patients (2.6%). Lesions were found predominantly in the peripheral (57.3%) and the lower lung region (60%). Conclusion: CT images of the COVID-19 patients showed various aspects, mainly GGO, consolidation, mixed GGO and consolidation, and air bronchogram. Lesion distribution was predominantly in lower lung region, bilateral and peripheral. Pleural effusion and multiple lobe involvement were significantly higher in the elderly group than that of the young and middle-aged group.

scholarly journals Concurrent sensitization to Aspergillus Fumigatus in tropical pulmonary eosinophilia

2016 ◽  
Vol 81 (1-2) ◽  
Author(s):  
Sunil K. Chhabra ◽  
Devi Jyoti Dash
Keyword(s):  
Aspergillus Fumigatus ◽  
Severe Asthma ◽  
Lung Tissue ◽  
Peripheral Blood ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Pulmonary Eosinophilia ◽  
Blood Eosinophilia ◽  
Future Risk ◽  
Serum Total Ige ◽  
Peripheral Blood Eosinophilia

<p>Tropical pulmonary eosinophilia (TPE) is characterized by lung tissue and peripheral blood eosinophilia. Serum total IgE is also markedly increased in TPE. However, an association with asthma or other hypersensitivity conditions has not been described. During the diagnostic workup of three patients eventually confirmed to have TPE, hypersensitivity to the fungus, <em>Aspergillus Fumigatus </em>was found. However, there was no evidence of diseases of aspergillus hypersensitivity such as severe asthma with fungal sensitization (SAFS) and allergic bronchopulmonary aspergillosis (ABPA). This association however raises the possibility of a future risk of these potentially serious allergic respiratory manifestations.</p><p><strong>Riassunto</strong></p><p>L’eosinofilia polmonare tropicale (TPE) è caratterizzata da tessuto polmonare e eosinofilia nel sangue periferico. Anche il siero IgE totale è notevolmente aumentato in TPE. Tuttavia, un’associazione con asma o altre condizioni di ipersensibilità non è stata descritta. Durante l'iter diagnostico di tre pazienti, che alla fine si sono rivelati presentare TPE, ipersensibilità al fungo, è stato trovato l’<em>Aspergillus fumigatus</em>. Tuttavia, non vi era alcuna evidenza di malattie di <em>Aspergillus</em> ipersensibilità come l'asma grave con sensibilizzazione fungina (SAF) e aspergillosi broncopolmonare allergica (ABPA). Questa associazione pone tuttavia la possibilità di un rischio futuro di queste potenzialmente gravi manifestazioni allergiche respiratorie.</p>

scholarly journals Chronic Active Epstein-Barr Virus-Associated Enteritis: CT Findings and Clinical Manifestation

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Bo Zhang ◽  
Xia Wang ◽  
Xiaoyan Tian ◽  
Yongping Cai ◽  
Xingwang Wu
Keyword(s):  
Epstein Barr Virus ◽  
Bowel Wall ◽  
Clinical Symptoms ◽  
Wall Thickening ◽  
Barr Virus ◽  
Ct Findings ◽  
Pathologic Findings ◽  
Bowel Wall Thickening ◽  
Epstein Barr ◽  
Fat Stranding

Aim. To improve the identification and computed tomography (CT) diagnostic accuracy of chronic active Epstein-Barr virus (EBV)-associated enteritis (CAEAE) by evaluating its CT findings and clinical manifestation. Methods. The data of three patients with pathologically and clinically confirmed CAEAE who underwent CT enterography (CTE) were retrospectively reviewed from January 2018 to October 2019. The following data were evaluated: imaging characteristics (length of involvement, pattern of mural thickening, pattern of attenuation, perienteric abnormalities), clinical symptoms, endoscopic records, laboratory examinations, and pathologic findings. Results. Based on CT findings, two patients demonstrated segmental bowel wall thickening (involvement length >6 cm), asymmetric thickening, layered attenuation, fat stranding, and adenopathy, whereas the remaining one had no positive finding. The endoscopic results of all patients showed numerous irregular ulcers in the colon, and one patient had a focal esophageal ulcer. The major clinical symptoms were abdominal pain (n=3), retrosternal pain (n=1), fever (n=3), diarrhea (n=2), hematochezia (n=1), and adenopathy (n=3). The main laboratory examination indicators were increased serum EBV DNA load (n=1) and increased inflammatory markers (n=3). With regard to the main pathologic findings, all patients showed positive EBV-encoded RNA (EBER) situ hybridization in the colonic biopsy specimen, with one patient being positive in the esophagus. Conclusion. CAEAE is rare and is usually misdiagnosed as inflammatory bowel disease (IBD). The imaging features of CAEAE overlap with those of Crohn’s disease and ulcerative colitis. The presence of segmental and asymmetric bowel wall thickening, layered attenuation, and fat stranding in the CTE image may be helpful in differentiating CAEAE from IBD.

S1549: Association Between Serum Albumin Levels and Computed Tomography (CT) Findings of Colon Wall Thickening (CWT)

2010 ◽  
Vol 71 (5) ◽  
pp. AB191-AB192
Author(s):  
Hiral Shah ◽  
Bikram S. Bal ◽  
Raman Battish ◽  
Michael D. Crowell ◽  
Rohini R. Vanga ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Serum Albumin ◽  
Wall Thickening ◽  
Colon Wall ◽  
Ct Findings

Longitudinal CT Assessment Of Airway Wall Thickening In Severe Asthma

2011 ◽  
Author(s):  
Chad Witt ◽  
David Gierada ◽  
James Kozlowski ◽  
Eric A. Hoffman ◽  
Janice Cook-Granroth ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Wall Thickening ◽  
Airway Wall

scholarly journals A scoring system based on computed tomography for the correct diagnosis of xanthogranulomatous cholecystitis

2020 ◽  
Vol 9 (4) ◽  
pp. 205846012091823 ◽  
Author(s):  
Ryota Ito ◽  
Takashi Kobayashi ◽  
Gou Ogasawara ◽  
Yoshiharu Kono ◽  
Kazuhiko Mori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Confidence Interval ◽  
Gallbladder Cancer ◽  
Scoring System ◽  
Correct Diagnosis ◽  
Chronic Cholecystitis ◽  
Wall Thickening ◽  
Xanthogranulomatous Cholecystitis ◽  
Ct Findings ◽  
Pericholecystic Abscess

Background Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis. The differential diagnoses of XGC include gallbladder cancer (GBC), adenomyomatosis, and actinomycosis of the gallbladder. Purpose To assess the usefulness of computed tomography (CT) findings in the diagnosis of XGC and differentiation from GBC. Material and Methods We retrospectively assessed the pathological and radiological records of 13 patients with pathologically proven XGC and 33 patients with GBC. Results Significant differences were observed for the following five CT findings: diffuse wall thickening (XGC = 85%, GBC = 15%, P < 0.01); absence of polypoid lesions (XGC = 100%, GBC = 48%, P < 0.01); intramural nodules or bands (XGC = 54%, GBC = 9%, P < 0.01); pericholecystic infiltration (XGC = 69%, GBC = 9%, P < 0.01); and pericholecystic abscess (XGC = 23%, GBC = 0%, P = 0.018). We defined the scoring system based on how many of the five CT findings were observed. Our scoring system, which included these findings, revealed that patients with three or more findings had sensitivity of 77% (95% confidence interval [CI] = 57–87) and specificity of 94% (95% CI = 86–98). Conclusion Our scoring system can assist in the differentiation of XGC from GBC.

scholarly journals Serum total IgE levels and total eosinophil counts: relationship with treatment response in patients with acute asthma

2010 ◽  
Vol 36 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Ebrahim Razi ◽  
Gholam Abbass Moosavi
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Pharmacological Treatment ◽  
Acute Asthma ◽  
Total Ige ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
White Blood Cell Counts ◽  
Serum Total Ige ◽  
Eosinophil Counts

OBJECTIVE: To determine whether serum total IgE levels and total eosinophil counts have any relationship with the response to routine pharmacological treatment in patients with acute asthma. METHODS: A cross-sectional study involving 162 patients with acute asthma. Serum total IgE levels, peripheral blood cell counts and eosinophil counts were determined. The treatment was adjusted for each patient according to the severity of asthma. Spirometry was performed at baseline and two weeks after the treatment. The patients were divided into two groups: high IgE (>100 IU/mL) and low IgE (<100 IU/mL). We compared the two groups in terms of the relationships between baseline values and final values (percentage change) for the following parameters: FEV1, FVC, FEF25-75%, peripheral white blood cell counts and eosinophil counts. RESULTS: There were no significant differences between the groups regarding the percentage changes of the studied parameters. Nor were there significant differences between the groups regarding FEV1, FVC, and FEF25-75% (% of the predicted values) at baseline. CONCLUSIONS: On the basis of these findings, we conclude that serum total IgE levels, peripheral white blood cell counts and eosinophil counts cannot predict the response to the pharmacological treatment of patients with acute asthma.

scholarly journals Electronic monitoring of adherence to inhaled corticosteroids: an essential tool in identifying severe asthma in children

2017 ◽  
Vol 50 (6) ◽  
pp. 1700910 ◽  
Author(s):  
Anja Jochmann ◽  
Luca Artusio ◽  
Angela Jamalzadeh ◽  
Prasad Nagakumar ◽  
Edgar Delgado-Eckert ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Electronic Monitoring ◽  
Inhaled Corticosteroids ◽  
Good Control ◽  
Clinical Parameter ◽  
Poor Adherence ◽  
Poor Control ◽  
Good Adherence ◽  
Asthmatic Children ◽  
Monitoring Devices

International guidelines recommend that severe asthma can only be diagnosed after contributory factors, including adherence, have been addressed. Accurate assessment of adherence is difficult in clinical practice. We hypothesised that electronic monitoring in children would identify nonadherence, thus delineating the small number with true severe asthma.Asthmatic children already prescribed inhaled corticosteroids were prospectively recruited and persistence of adherence assessed using electronic monitoring devices. Spirometry, airway inflammation and asthma control were measured at the start and end of the monitoring period.93 children (62 male; median age 12.4 years) were monitored for a median of 92 days. Median (range) monitored adherence was 74% (21–99%). We identified four groups: 1) good adherence during monitoring with improved control, 24% (likely previous poor adherence); 2) good adherence with poor control, 18% (severe therapy-resistant asthma); 3) poor adherence with good control, 26% (likely overtreated); and 4) poor adherence with poor control, 32%. No clinical parameter prior to monitoring distinguished these groups.Electronic monitoring is a useful tool for identifying children in whom a step up in treatment is indicated. Different approaches are needed in those who are controlled when adherent or who are nonadherent. Electronic monitoring is essential in a paediatric severe asthma clinic.

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