Pulmonary toxicity bronchioles

Interferon alfa was also suspected to be involved in one case of biopsy-proven bronchiolitis obliterans-organizing pneumonia (41). Clinical symptoms of pneumonitis appeared 3-12 weeks after the onset of interferon alfa therapy, and after withdrawal of treatment they usually completely resolved, either spontaneously or after a short course of glucocorticoid treatment. Immune-mediated pulmonary toxicity involving the activation of T cells was considered as a likely mechanism. The uncommon features of bronchiolitis obliterans-organizing pneumonia have been reported in three other patients who received interferon alfa together with ribavirin or cytosine arabino-side (42,43). 

In a retrospective review of 70 patients with hepatitis C enrolled in four clinical trials, there were four cases of significant pulmonary toxicity (two of bronchiolitis obliterans and two of interstitial pneumonitis) (45). Three recovered completely, but one still required glucocorticoids for exertional dyspnea that persisted 17 months after interferon alfa withdrawal. The authors suggested that there was an increased risk with high-dose interferon, because three of these patients received high doses (5 MU/day) or pegylated interferon alfa. In contrast, they were unaware of any significant pulmonary... 

Acute pulmonary edema Diffuse alveolar hemorrhage Periengraftment respiratory distress syndrome Bronchiolitis obliterans syndrome Bronchiolitis obliterans organizing pneumonia Idiopathic pulmonary syndrome Delayed pulmonary toxicity syndrome Pulmonary cytolytic thrombi Pulmonary veno-occlusive disease Progressive pulmonary fibrosis Pulmonary hypertension Hepatopuhnonary S3mdrome Pulmonary alveolar proteinosis Eosinophilic pneumonia... 

D-Penicillamine is used in the treatment of rheumatoid arthritis. Several types of pulmonary toxicities have been described with this agent. A pulmonary-renal syndrome similar to Goodpasture s syndrome has been rarely described and is fatal in 50% of the cases. Hemoptysis and hematuria are present in an acute fashion and warrant prompt discontinuation of the drug. Anti-glomerular basement membrane antibodies are not found and the role of plasmapheresis in undetermined. Treatment with corticosteroids or immunosuppressive agents may be of benefit (21). Bronchiolitis obliterans with or without organizing pneumonia has also been reported, but is also described with rheumatoid arthritis. Hypersensitivity pneumonitis and the subacute onset of pulmonary fibrosis have been... 

Clara cells are rxinciliated cells in the small bronchioles that contain a relatively high concentration of cytochrome P-450. Therrf, they are equipped to metabolize xenobiolics, and they may bioactivate chemicals to a mote active or mote toxic form. They are often a target for pulmonary toxicants. 

Respiratory toxicity Upper respiratory system (nose, pharynx, larynx, and trachea) and the lower respiratory system (bronchi, bronchioles, and lung alveoli) Pulmonary irritation Asthma/bronchitis Emphysema Allergic alveolitis Fibrotic lung disease Lung cancer... 

The toxicity of NO2 is often studied since it is a major component of air pollution however, a safe level is difficult to determine. A confounding effect is a certain tolerance to later NO exposure after a preliminary low-level exposure for a brief time (Mustafa and Tierney, 1978). NO2 levels of less than 0.5 ppm have been reported to enhance human airway hyperreactivity (Bylin et al., 1988). Toxic pulmonary effects of breathing NO2 at or below 5 ppm have been reported. These include altered surfactant chemistry and metabolism (Muller et al., 1994), epithelial hyperplasia of the terminal bronchioles, and increased cellularity of the alveoli in rats (Evans et al.,... 

C. Sequelae. Although most patients who suffer toxic inhalation injury will recover without any permanent impairment, bronchiectasis, bronchiolitis obliterans, persistent asthma, and pulmonary fibrosis can occur. 

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