Uveitis as a presenting feature of chronic sarcoidosis.

Uveitis is often a manifestation of sarcoidosis. Less well-recognized, however, is the development of uveitis several years before the diagnosis of systemic sarcoidosis. The possibility that presentation of uveitis is a marker for the chronicity of sarcoidosis has never been investigated.

Nephrolithiasis as a presenting feature of chronic sarcoidosis.

Background: Renal calculi have been reported to occur in about 10% of patients with chronic sarcoidosis, but nephrolithiasis as a presentation of this disease has not been studied.

Methods: The charts of 618 patients with histologically proven sarcoidosis, seen in the period October 1978-1992, were reviewed in order to identify nephrolithiasis at presentation.

Results: Seventeen patients had renal calculi which preceded other manifestations of sarcoidosis.

Efficacy of a three day course of azithromycin in moderately severe community-acquired pneumonia.

This study was designed to evaluate the efficacy of a 3 day course of azithromycin in low to moderately severe community-acquired pneumonia. Forty patients with low to moderately severe community-acquired pneumonia (29 males, 11 females, mean age 46 +/- 17 yrs; 20 pretreated with betalactams for 2-10 days with no results before admission to hospital; 18 with evidence of co-morbidity) were enrolled in an open, randomized study with azithromycin, 500 mg q.d.

The differential diagnosis of hard metal lung disease.

Hard metal lung disease is usually easy to diagnose, on the basis of occupational history, chest X-ray appearance of interstitial lung disease and, if necessary, by bronchoalveolar lavage (BAL). However, other interstitial lung diseases may affect patients with an occupational history of exposure to cobalt. In hard metal disease, the hylar lymphnodes may enlarge due to high draining of hard metals from the lung tissue via lymphatic vessels.

Gastrointestinal presentation of Churg Strauss syndrome.

Gastrointestinal involvement is frequent in patients with Churg Strauss Syndrome: clinical symptoms (abdominal pain, diarrhea or bleeding) range from 44 to 89%, pathologic involvement of the bowel from 33 to 92%, and gastrointestinal death (bleeding or perforation), described in 8% of cases, is the fourth leading cause of death after heart, CNS and renal failure. In spite of this wide-spread digestive involvement, gastrointestinal presentation has never been described. We present a 56 year old man with Churg Strauss Syndrome, where eosinophilia, diarrhea and gastrointestinal bleeding appeared three years before asthma.

Multi-element follow up in biological specimens of hard metal pneumoconiosis.

The movement of Co and the other components of the hard metal in the body fluids, their solubility, their links to the cells and proteins of the body, and their clearance are largely unknown. The first aim of this work is to evaluate whether Neutron Activation Analysis (NAA), a new analytical technique based on the radiochemical separation of samples irradiated in a Nuclear Reactor, may be suitable for studying the movement of elements in tissues or body fluids of workers over time. We have investigated seven hard metal workers, all employed in the grinding process, with NAA studies (single study in two, follow-up in five) of 29 elements on lung tissue, BAL fluid, blood, urine, pubic hair, toenails and sperm.

Prevention of corticosteroid-induced osteoporosis with salmon calcitonin in sarcoid patients.

The aim of this study was to evaluate the usefulness of salmon calcitonin (sCT) in preventing corticosteroid-induced osteoporosis. Three groups of patients with sarcoidosis requiring long-term steroid therapy were followed for 2 years with yearly evaluations of vertebral cancellous mineral content (VCMC) by quantitative computed tomography. The first group (n = 18) was treated with intramuscular (i.

Bone loss in untreated longstanding sarcoidosis.

The introduction of new techniques for the study of Bone Mineral Content (BMC) has not yet been extensively applied to sarcoidosis. Using Quantitative Computed Tomography (QCT) in a long-term prednisone-treated sarcoid population we have shown in 1988 [1] that Bone Mineral Loss is more frequent than elsewhere reported with other techniques on patients with different diseases. It was not clear if this difference was due to the sarcoidosis itself or to the better sensitivity of QCT compared to former techniques [2].

Long-term therapy with deflazacort in chronic sarcoidosis.

Purpose: To evaluate the long-term action of deflazacort (DF), a new calcium-sparing and bone-saving corticosteroid, in chronic sarcoidosis patients needing prolonged therapy.

Patients And Methods: 40 patients with chronic histologically proved sarcoidosis requiring long-term corticosteroid therapy were treated with DF and followed for a mean period of 958 +/- 515 days (range 382-2, 068). The indication for giving corticosteroid therapy was pulmonary impairment in most (36), but also other events including hypercalcemia (2), kidney stones (5, 2 with recurrent colic), uveitis (2), lupus pernio (3), suspected heart impairment (5), hypersplenism (1), and other causes.

Retroperitoneal involvement in sarcoidosis.

The presence of retroperitoneal lymphnodes is well known in sarcoidosis. We observed in two patients unilateral hydronephrosis (asymptomatic in one; dysuria in the other), and in one patient urine retention due to compression of both ureters; this patient also had jaundice due to lymphnode compression of the biliary tract. In another four patients we noted retroperitoneal lymphnodes without compression.

Bone loss in prednisone treated sarcoidosis: a two-year follow-up.

We followed up 35 sarcoid patients treated with prednisone for two years in order to evaluate bone mineral loss over time. Vertebral cancellous mineral content was detected by quantitative computed tomography and calibration phantom before beginning prednisone therapy and monitored two more times at yearly intervals. The percent mineral loss (ML%) averaged -13.

Trace metal lung disease: in vitro interaction of hard metals with human lung and plasma components.

Hard metal pneumoconiosis is an occupational pulmonary disease caused by long-term exposure to dust produced in the hard metal industry. In vitro experiments have been carried out to study the solubility and metabolic behaviour in human lung tissue and plasma of hard metal alloy constituents such as cobalt, tungsten, tantalum, titanium and niobium. The experiments were carried out using 60Co, 187W, 182Ta, 44Ti and 95Nb radiotracers in combination with neutron activation, radio-release tests and gel filtration techniques.

Spontaneous regression of amiodarone pulmonary toxicity.

Two patients with Amiodarone-induced interstitial lung disease are described. The pulmonary lung biopsy in one of them, as well as Chest X ray, BAL cellularity and pulmonary function data in both, are in agreement with the reports from the literature, while Ga lung scan was negative in one of the two, and positive in the other one. In both, a total resolution was seen six and four months respectively after discontinuation of Amiodarone therapy.