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Published byTravon Leming
Modified over 2 years ago
Roy Temes MD MBA, Joseph Lahorra MD, Inderjit Gill MD, Joseph Tomashefski Jr. MD, Thomas Rice MD
26 year old with progressing interstitial lung disease over 1.5 years Reformed IV drug user, HIV negative
Robotic wedge biopsy, discharged following day Pathology: Talc induced pulmonary granulomas (TIPG) Cultures (including AFB) negative
Cause: Injected tablet adulterants and fillers (talc, cellulose, fibers, other) Result: Loss of pulmonary vasculature, pulmonary hypertension, RVH Treatment (1): Medical: Steroids (inhaled budesonide), vasodilators (hydralazine) Treatment (2): Surgical: Lung transplantation Outcome: Pulmonary insufficiency and/or death
Include TIPG in differential diagnosis of interstitial disease in appropriate clinical setting Findings pathognomonic for drug abuse
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Case study 35 Year old male. Background HIV Positive – Stavudine/Lamivudine/Lopinavir Ritonavir combination Renal Failure for 2 years Receive a transplant.
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R1 정수웅. Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown cause that occurs.
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