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Pulmonary complications of drug therapy
VOLUME 41 NUMBER 6
Abstracts
45
pneumothorax were not considered severe enough to warrant cessation of CPPV when weighed against the effects of prolonged hypoxemia. The authors suggest tliat improvement in Pao, and intrapulmonary shunt may be due to prevention of air space collapse during expiration and increase in functional residual capacity. They believe the major value of CPPV is to prevent early hypoxemic death. J. S.
Pulmonary complications of drug therapy. Brettner, A., Heitzman, E. E., and Woodin, W . G.: Radiology 96: 31,1970. A radiologic review of the pulmonary complications of drug therapy, resulting from allergic and occasionally idiosyncratic reactions, is presented. Clinically these reactions may be acute, subacute, or chronic in nature, with symptoms occurring either immediately or after years of therapy. Acute onsets are characterized by a sudden development of chills, fever, cough, and dyspnea. Occasionally, generalized hypersensitivity reactions manifested by fever, fatigue, skin rash, conjunctivitis, hepatosplenomegaly, lymphadenopathy, pancytopenia, and eosinophilia occur. The following changes have been observed in the lung as a result of adverse drug reactions. First an acute and frequently diffuse alveolar pattern often perihilar in distribution and resembling pulmonary edema with or without hypersensitivity manifestations may be seen. This is the most common type of reaction and is caused by sulfadimethoxine (Madribon), sulfaohrysoindine (Prontosil), paraaminosalicylic acid ( P A S ) , and penicillin. The second type of reaction is an acute and diffuse interstitial pattern, with or without other hypersensitivity signs, and occasionally recurrent bouts of idiopathic pulmonary edema are a clue to the diagnosis. Hydrochlorothiazide (Diuril) and pteroylglutamic acid (methotrexate) may produce such reactions. The third type of reaction manifested by chronic interstitial fibrotic patterns may be caused by nitrofurantoin (also acute interstitial), busulphan, hexamethonium, mecamylamine, or methysergide. Pleuropulmonary or lupus-like reactions are the fourth type and simulate a collagen disease being characterized by linear, basilar, and parenchymal shadows accompanied by pleural effusion and resulting from the administration of procainamide (Pronestyl). Finally hilar adenopathy patterns associated with other signs of hypersensitivity may occur not only from commonly used anticonvulsants (phenylhydantoin) but also from potassium iodides.
S. F.
Immunology X-ray resistant cell required for the induction of in vitro antibody formation.
Eoseman, J.: Science 165: 3898, 1969. Mouse spleen cells may be separated into two population types by their ability to adhere to plastic. Macrophages, comprising 10 per cent of the cell population, adhere to plastic, whereas small lymphocytes lack this ability. Both types are necessary for the in vitro response to sheep red blood cells (S-EBC). The antigen has to come into contact with either a mixed spleen cell population or the adherent cell group in order for there to be an anti-SEBC reaction. Irradiation of mice, followed by antigenic stimulation with S-EBC, or immunizing splenic cell cultures from irradiated mice with S-EBC gave similar values for anti-S-EBC activity as evidenced by hemolytic plaque formation (modified Jerne technique). When adherent cells from x-irradiated mice were combined with nonadherent cells from normal mice and when adherent cells from normal mice were combined with nonadherent cells from x-irradiated mice, it was found that the x-ray exposure undid that p a r t of the immunologic response provided by the nonadherent (small lymphocyte) cells. I t was further found that the addition of normal thymus cells to irradiated adherent cell cultures did not restore the
Abstracts
45
pneumothorax were not considered severe enough to warrant cessation of CPPV when weighed against the effects of prolonged hypoxemia. The authors suggest tliat improvement in Pao, and intrapulmonary shunt may be due to prevention of air space collapse during expiration and increase in functional residual capacity. They believe the major value of CPPV is to prevent early hypoxemic death. J. S.
Pulmonary complications of drug therapy. Brettner, A., Heitzman, E. E., and Woodin, W . G.: Radiology 96: 31,1970. A radiologic review of the pulmonary complications of drug therapy, resulting from allergic and occasionally idiosyncratic reactions, is presented. Clinically these reactions may be acute, subacute, or chronic in nature, with symptoms occurring either immediately or after years of therapy. Acute onsets are characterized by a sudden development of chills, fever, cough, and dyspnea. Occasionally, generalized hypersensitivity reactions manifested by fever, fatigue, skin rash, conjunctivitis, hepatosplenomegaly, lymphadenopathy, pancytopenia, and eosinophilia occur. The following changes have been observed in the lung as a result of adverse drug reactions. First an acute and frequently diffuse alveolar pattern often perihilar in distribution and resembling pulmonary edema with or without hypersensitivity manifestations may be seen. This is the most common type of reaction and is caused by sulfadimethoxine (Madribon), sulfaohrysoindine (Prontosil), paraaminosalicylic acid ( P A S ) , and penicillin. The second type of reaction is an acute and diffuse interstitial pattern, with or without other hypersensitivity signs, and occasionally recurrent bouts of idiopathic pulmonary edema are a clue to the diagnosis. Hydrochlorothiazide (Diuril) and pteroylglutamic acid (methotrexate) may produce such reactions. The third type of reaction manifested by chronic interstitial fibrotic patterns may be caused by nitrofurantoin (also acute interstitial), busulphan, hexamethonium, mecamylamine, or methysergide. Pleuropulmonary or lupus-like reactions are the fourth type and simulate a collagen disease being characterized by linear, basilar, and parenchymal shadows accompanied by pleural effusion and resulting from the administration of procainamide (Pronestyl). Finally hilar adenopathy patterns associated with other signs of hypersensitivity may occur not only from commonly used anticonvulsants (phenylhydantoin) but also from potassium iodides.
S. F.
Immunology X-ray resistant cell required for the induction of in vitro antibody formation.
Eoseman, J.: Science 165: 3898, 1969. Mouse spleen cells may be separated into two population types by their ability to adhere to plastic. Macrophages, comprising 10 per cent of the cell population, adhere to plastic, whereas small lymphocytes lack this ability. Both types are necessary for the in vitro response to sheep red blood cells (S-EBC). The antigen has to come into contact with either a mixed spleen cell population or the adherent cell group in order for there to be an anti-SEBC reaction. Irradiation of mice, followed by antigenic stimulation with S-EBC, or immunizing splenic cell cultures from irradiated mice with S-EBC gave similar values for anti-S-EBC activity as evidenced by hemolytic plaque formation (modified Jerne technique). When adherent cells from x-irradiated mice were combined with nonadherent cells from normal mice and when adherent cells from normal mice were combined with nonadherent cells from x-irradiated mice, it was found that the x-ray exposure undid that p a r t of the immunologic response provided by the nonadherent (small lymphocyte) cells. I t was further found that the addition of normal thymus cells to irradiated adherent cell cultures did not restore the