Granuloma, interstitial

Beryllium Ore extraction, manufacture of alloys, ceramics Dyspnea, interstitial granuloma, fibrosis, corpulmonae, chronic disease... 

AIN is characterized by fever, eosinophilia, hematuria, mild proteinuria and skin rash occur an average of 15 days after exposure (range 2-40). Rising serum creatinine concentration and acute renal failure with oliguria develop in about 50% of AIN cases, especially in older patients. Histologically, interstitial granulomas and variable degrees of tubular necrosis may be seen on renal biopsy. 

Wada DA, Perkins SL, Tripp S, et al. Human herpesvirus 8 and iron staining are useful in differentiating Kaposi sarcoma from interstitial granuloma annulare. Am J Clin Pathol. 2007 127 263-270. 

Ahmad U, Li X, Sodeman T, Daboul I. Hepatitis C virus treatment with pegylated interferon-alfa therapy leading to generalized interstitial granuloma annulare and review of the literature. Am J Ther 2013 20 585-7. 

MagU AB. Drug-induced acute interstitial nephritis with granulomas. Hum Pathol 1983 14(1) 36-41. 

The manufacturers have on record in the USA several pulmonary adverse effects during isotretinoin therapy, including worsening of asthma (SEDA-21,162), recurrent pneumothorax, pleural effusion, interstitial fibrosis, pulmonary granuloma, and deterioration in lung function tests. Exercise-induced asthma (35) may be caused by a significant reduction in the forced expiratory flow rate (36) and a drying effect of isotretinoin on the mucous membranes of the respiratory tract (37). 

Tables. Outcome of drug-induced acute interstitial nephritis with and without granulomas (modified from ref. [61]).

As the glomerular filtrate proceeds down the tubule, the filtrate becomes increasingly concentrated and the pH of the filtrate becomes more acidic. Therefore chemicals with pH-dependent solubility have the potential to precipitate and cause tubular obstruction, resulting in local interstitial inflammation, granuloma formation, and fibrosis. Indinavir is a protease inhibitor used in the treatment of immunodeficiency virus that has been reported to cause renal toxicity. The solubility of indinavir is pH- and flow-dependent, and some patients treated with indinavir form urinary crystals that obstruct tubules, leading to inflammation or granuloma formation, resulting in renal failure [23]. 

GI upset, paresthesias, dizziness, tremor, confusion, nightmares, psychotic reactions, coma, seizures, rash, fever, arthralgia, agranulocytosis, aplastic anemia, thrombocytopenia, hepatic granulomas, interstitial pneumonitis... 

CHRONIC HEALTH RISKS produces talcosis due to talc, silica and asbestos (talc pneumoconiosis) productive cough dyspnea rales diminished breath sounds limited chest expansion interstitial fibrosis granulomas chronic talc inhalation may increase the risk of bronchogenic carcinoma pneumoconiosis associated with obstructive and restrictive lung disease has been reported. 

E. Tularemia. Franciseila tularensis bacteria usually cause infection by exposure to bodily fluids of Infected animals or from the bites of ticks or mosquitoes. Aerosolized bacteria can also be Inhaled. An initial focal, suppurative necrosis is followed by bacterial multiplication within macrophages and dissemination to lymph nodes, lungs, spleen, liver, and kidneys. In the lungs, the lesions progress to pneumonic consolidation and granuloma formation and can result in chronic interstitial fibrosis. 

Information derived from a variety of experimental animal models suggests that a number of cytokines play a role in the initiation, maintenance, and resolution of chronic interstitial pulmonary inflammation. However, the mechanism by which each cytokine is involved in the evolution of the inflammatory response is not clear. For example, in vivo studies assessing the development of interstitial lung granulomas induced by a mycobacterial antigen, purified protein derivative (PPD), have demonstrated that IFN-y and TNF were necessary cytokines for lesion progression (52). In contrast, pulmonary inflammation initiated by either the... 

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