Primary pulmonary hypertension: its association with microangiopathic hemolytic anemia and thrombocytopenia

Article Abstract:

Primary pulmonary hypertension is a disease of unknown cause, which is characterized by elevated blood pressure in the circulation of the lung. This puts considerable strain on the right side of the heart, which is responsible for the lungs' circulation, and ultimately results in death within a few years of diagnosis. Most patients are young, and most are women. Four cases of primary pulmonary hypertension with some unusual features in common are described. All four patients were found on admission to the hospital to have a particular anemia resulting from microangiopathic hemolysis, or fragmentation of red blood cells within small blood vessels. The patients also had thrombocytopenia, or low platelet counts (platelets are tiny blood cells necessary for blood to clot). All four patients died suddenly within days of admission. At autopsy, the four patients were found to have plexiform lesions of the blood vessels of the lungs, which are similar to webs of abnormal blood vessels with protein deposits in their walls. The fibrous proteins probably shear the red blood cells as they travel through these webs, resulting in a picture of microangiopathic hemolytic anemia. Prior to this report, only one patient with primary pulmonary hypertension and microangiopathic hemolytic anemia and thrombocytopenia had ever been described. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Abnormalities, Causes of, Blood vessels, Hemolytic anemia, Pulmonary hypertension, Thrombocytopenia

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Routine chest radiographs in exacerbations of chronic obstructive pulmonary disease: diagnostic value

Article Abstract:

The economic and clinical diagnostic value of routine chest X-rays was evaluated in 242 patients who were hospitalized with a flare-up of chronic obstructive lung disease. Included in this disease classification are asthma and emphysema, diseases that make it difficult to move air into and out of the lungs. All patients with a diagnosis of chronic obstructive pulmonary disease during a one-year period at a particular hospital were included in the study population. From this base of patients, chest X-rays were found to be abnormal in only 35 patients or 14 percent, and were only found to indicate modifications of therapy in 11 cases or 4.5 percent of all patients. The authors believe that a screening procedure which examines white blood cell count and other clinical findings could prevent the overuse of routine chest films.

Research, Asthma, Lung diseases, X-rays, Emphysema, Pulmonary, Emphysema, Diagnosis, Radioscopic, Radioscopic diagnosis

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Unsuspected pulmonary tuberculosis in a community teaching hospital

Article Abstract:

Tuberculosis remains a significant public health problem in the United States. The records from a four-year period at a 500-bed teaching hospital were reviewed to learn whether or not those patients diagnosed with tuberculosis were suspected of the disease on their initial examination. Tuberculosis of the lung was not suspected in 13 out of 31 patients who had an active disease. These patients were elderly, had a delay in being isolated from other persons, had a delay in diagnosis and experienced a longer hospitalization and more deaths than the other 18 tuberculosis patients. Inadequate diagnosis may contribute to the persistence of death and disease from tuberculosis in this country.

Diagnosis, Prevention, Communicable diseases, Tuberculosis, Hospitals, Teaching, Teaching hospitals

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