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Title: Immune complexes, gallium lung scans, and bronchoalveolar lavage in idiopathic interstitial pneumonitis-fibrosis

Abstract

We obtained results of lung immune complexes (LIC), circulating immune complexes (CIC), 48-hour gallium lung scans (scans), bronchoalveolar lavage (BAL), and pulmonary function tests in 20 patients with idiopathic interstitial pneumonitis-fibrosis. Sixteen patients had predominantly interstitial (13 cases UIP) and/or intraalveolar (3 cases DIP) cellular disease (group 1). Prior to corticosteroid therapy in group 1, scans were positive in 75 percent, CIC were elevated in 86 percent, LIC were present in 64 percent, and BAL was abnormal in 90 percent. Duration of follow-up after treatment was 3.5 +/- 1.0 year. In group 1 after treatment with corticosteroids in 13 patients and corticosteroids and penicillamine (three patients) and plasmapheresis (one patient), only four patients remain stable or improved. After corticosteroid therapy, elevated CIC returned to normal values despite progressive patient deterioration. In three patients, lung immune complexes were still detected after circulating immune complexes had returned to normal after corticosteroid therapy. In group 2 were four patients with fibrotic disease; scans and CIC were uniformly negative, LIC were weakly present in only one patient, and BAL was abnormal in all. Despite corticosteroid therapy, all have died or deteriorated. These results suggest that positive gallium lung scans, BAL, circulating immune complexes, andmore » to a lesser extent, lung immune complexes are associated with the cellular phase of interstitial pneumonia, but do not reliably identify a corticosteroid-responsive group.« less

Authors:
; ; ; ; ; ; ;
Publication Date:
Research Org.:
Pulmonary Division, Doctors Hospital of Lakewood, California
OSTI Identifier:
5534042
Resource Type:
Journal Article
Journal Name:
Chest; (United States)
Additional Journal Information:
Journal Volume: 84:2
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; GALLIUM ISOTOPES; DIAGNOSTIC USES; LUNGS; SCINTISCANNING; PNEUMONIA; IMMUNE REACTIONS; PNEUMONITIS; CORTICOSTEROIDS; DYNAMIC FUNCTION STUDIES; IMMUNOGLOBULINS; LAVAGE; PATIENTS; PENICILLAMINE; THERAPY; ADRENAL HORMONES; AMINO ACIDS; BODY; CARBOXYLIC ACIDS; CHELATING AGENTS; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DISEASES; DRUGS; GLOBULINS; HORMONES; HYDROXY COMPOUNDS; ISOTOPES; KETONES; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANIC SULFUR COMPOUNDS; ORGANS; PREGNANES; PROTEINS; RADIOISOTOPE SCANNING; RADIOPROTECTIVE SUBSTANCES; RESPIRATORY SYSTEM; RESPIRATORY SYSTEM DISEASES; STEROID HORMONES; STEROIDS; THIOLS; USES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Gelb, A F, Dreisen, R B, Epstein, J D, Silverthorne, J D, Bickel, Y, Fields, M, Border, W A, and Taylor, C R. Immune complexes, gallium lung scans, and bronchoalveolar lavage in idiopathic interstitial pneumonitis-fibrosis. United States: N. p., 1983. Web. doi:10.1016/S0012-3692(15)33478-4.
Gelb, A F, Dreisen, R B, Epstein, J D, Silverthorne, J D, Bickel, Y, Fields, M, Border, W A, & Taylor, C R. Immune complexes, gallium lung scans, and bronchoalveolar lavage in idiopathic interstitial pneumonitis-fibrosis. United States. https://doi.org/10.1016/S0012-3692(15)33478-4
Gelb, A F, Dreisen, R B, Epstein, J D, Silverthorne, J D, Bickel, Y, Fields, M, Border, W A, and Taylor, C R. 1983. "Immune complexes, gallium lung scans, and bronchoalveolar lavage in idiopathic interstitial pneumonitis-fibrosis". United States. https://doi.org/10.1016/S0012-3692(15)33478-4.
@article{osti_5534042,
title = {Immune complexes, gallium lung scans, and bronchoalveolar lavage in idiopathic interstitial pneumonitis-fibrosis},
author = {Gelb, A F and Dreisen, R B and Epstein, J D and Silverthorne, J D and Bickel, Y and Fields, M and Border, W A and Taylor, C R},
abstractNote = {We obtained results of lung immune complexes (LIC), circulating immune complexes (CIC), 48-hour gallium lung scans (scans), bronchoalveolar lavage (BAL), and pulmonary function tests in 20 patients with idiopathic interstitial pneumonitis-fibrosis. Sixteen patients had predominantly interstitial (13 cases UIP) and/or intraalveolar (3 cases DIP) cellular disease (group 1). Prior to corticosteroid therapy in group 1, scans were positive in 75 percent, CIC were elevated in 86 percent, LIC were present in 64 percent, and BAL was abnormal in 90 percent. Duration of follow-up after treatment was 3.5 +/- 1.0 year. In group 1 after treatment with corticosteroids in 13 patients and corticosteroids and penicillamine (three patients) and plasmapheresis (one patient), only four patients remain stable or improved. After corticosteroid therapy, elevated CIC returned to normal values despite progressive patient deterioration. In three patients, lung immune complexes were still detected after circulating immune complexes had returned to normal after corticosteroid therapy. In group 2 were four patients with fibrotic disease; scans and CIC were uniformly negative, LIC were weakly present in only one patient, and BAL was abnormal in all. Despite corticosteroid therapy, all have died or deteriorated. These results suggest that positive gallium lung scans, BAL, circulating immune complexes, and to a lesser extent, lung immune complexes are associated with the cellular phase of interstitial pneumonia, but do not reliably identify a corticosteroid-responsive group.},
doi = {10.1016/S0012-3692(15)33478-4},
url = {https://www.osti.gov/biblio/5534042}, journal = {Chest; (United States)},
number = ,
volume = 84:2,
place = {United States},
year = {Mon Aug 01 00:00:00 EDT 1983},
month = {Mon Aug 01 00:00:00 EDT 1983}
}