Respiratory Diseases

Chronic Obstructive Pulmonary Disease

Causes of Chronic Obstructive Lung Disease

Chronic obstructive lung disease or chronic obstructive pulmonary disease (COPD) is a very common problem that consists of chronic bronchitis and emphysema. It is common knowledge that COPD may be caused by cigarette smoking. In fact up to 90% or more of the COPD cases may be caused by smoking and it is the most common cause. However, there are many other etiologies for this disease that need to be considered. These include occupational exposure, air pollution, genetics, or autoimmune processes.

Occupation exposure is a known cause for COPD. People that work in coal mines, gold mines, textile factories, welding jobs, or jobs that involve working with cadmium or silicone are examples occupations that often lead to COPD. As an example of how real this is, you can see commercials by lawyers that promise big rewards for suing companies that exposed their workers to these chemicals without proper protection. This also leads to the point that certain occupation exposures can lead to other health problems as well (such as cancers or silicosis). However, keep in mind that this is still not as major a risk factor as cigarette smoking.

Air pollution is another cause of COPD. This is more of an issue in larger cities where there are a lot more automobile traffic producing the harmful gasses that can cause COPD. Besides outdoor air pollution, indoor air pollution can also occur (for example from not have having ventilated living areas and being exposed to chemicals or toxins from burning fuel inside a home).

Genetics (what you get from your parents) is another possible cause for COPD. Some people are more prone to get COPD than others. This explains why some people can smoke all their life and still not get lung cancer or COPD (because they have genes that allow them to repair damage caused by cigarette smoke).

An autoimmune process is another etiology to consider when thinking about causes of chronic obstructive lung disease. It has been observed that there are inflammatory processes (caused by the body’s own immune cells) going on in the lungs of COPD patients. This is a process that is independent of smoking but may be triggered by smoking and then continue on its own (even after the person stops to smoke).

In conclusion, we must realize that smoking is the most common cause of COPD or chronic obstructive lung disease but we should also be aware of other causes of this debilitating disorder.

Cryptogenic Organizing Pneumonia

Cryptogenic Organizing pneumonia (COP) is also known as Bronchiolitis obliterans organizing pneumonia. Using COP is preferred to avoid mixing up with brochiolitis obliterans. Cryptogenic organizing pneumonia is essentially inflammation of the bronchioles and also the surrounding tissue of the lungs. It is suspected that prior inflammatory conditions and certain drugs may cause COP. Although COP presents similar to pneumonia (such as the pneumonia caused by streptococcus pneumonia bacteria), a diagnosis of COP is often indicated when treatment with antibiotics fails and sputum cultures turn up negative for any organisms.

Why is it called organizing?

This term organizing refers to the presence of exudates and fibrosis tissue in and around alveolar tissue. This is from the unresolved pneumonia. In normal (bacterial) pneumonia, the exudates would have resolved with anti-bacterial treatment.

What type of symptoms to patients with COP have?

Most common symptoms include those similar to a bacterial pneumonia. These include cough, shortness of breath, flu like symptoms, crackles on lung exam, and fevers. Weight loss is also common

What is the incidence of COP?

Most patients are between the ages of 40 and 60. COP effects about .01% of people. Males are just as likely as females to get this disease. It can be deadly – often killing 7% of people effected.

Tratment of COP:

Treatment involves giving the patient corticosteroids. This is dosed by the weight of the patient at about .75 mg/Kg (which typically leads to starting dose of about 50 mg per day). Corticosteroids can have side-effects and the patient has to be slowly taken off the medication. Most patients will recover and other medications may be provided to counter the side-effects of corticosteroids.

Pneumonia

Definition of Pneumonia
Symptoms of Pneumonia
Causes of Pneumonia
Treatment of Pneumonia

Definition of Pneumonia:
Pneumonia itself is described as an inflammation of the lungs (specifically the lung tissue and alveoli). Besides inflammation (consolidation), there is also involved exudate (or filling of the lungs with fluid).

Symptoms of Pneumonia:
Typical symptoms of pneumonia include production of sputum, chills, shortness of breath, and chest pain.

Causes of Pneumonia:
Pneumonia can be caused by bacteria (Bacterial Pneumonia), viruses (Viral Pneumonia), fungi (Fungal Pneumonia), or parasites (Parasitic Pneumonia). In some cases the cause may be unknown (idiopathic).

Treatment of Pneumonia:

The treatment will depend on the cause of the pneumonias. In bacterial pneumonia, antibiotics will be used depending on the causative organisms. Antibiotics can also be used in preventing bacterial pneumonia from developing in a patient that already has a viral pneumonia. Antiviral can help in the treatment of viral pneumonias.

Pulmonary Hypertension

Pulmonary hypertension refers to the abnormal elevation fo pulmonary artery pressure.

There are 2 types of Pulmonary HTN:
1) Primary Pulmonary HTN (idiopathic)
2) Secondary pulmonary HTN (associated with an underlying disease/process)

Primary Pulmonary Hypertension

Primary Pulmonary Hypertension refers to an abnormally elevated blood pressure of the pulmonary artery for which the cause is unknown.

There is an increase in pulmonary vascular resistance, an increased pulmonary artery pressure, and certain changes in the pathology.

Pathological changes in Primary Pulmonary HTN:
-Hypertrophy and fibrosis of the vascular bed
-In situ thrombosis

pulmonary hypertension artery with fibrosis and hypertrophy