Michael at 05:31, 13 March 2015

2015-03-13T05:31:40Z

← Older revision		Revision as of 05:31, 13 March 2015
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	'''Asthma''' is a common respiratory disease. It occasionally can be fatal and may be seen in the context of [[forensic pathology]].		'''Asthma''' is a common respiratory disease. It occasionally can be fatal and may be seen in the context of [[forensic pathology]].

	The [[cytopathology]] of asthma is dealt with in ''[[Pulmonary_cytopathology#Asthma\|~~asthma in~~ pulmonary cytopathology]]''.		The [[cytopathology]] of asthma is dealt with in ''[[Pulmonary_cytopathology#Asthma\|pulmonary cytopathology (asthma)]]''.

	==General==		==General==

Michael at 05:31, 13 March 2015

2015-03-13T05:31:19Z

← Older revision		Revision as of 05:31, 13 March 2015
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	'''Asthma''' is a common respiratory disease. It occasionally can be fatal and may be seen in the context of [[forensic pathology]].		'''Asthma''' is a common respiratory disease. It occasionally can be fatal and may be seen in the context of [[forensic pathology]].

	The [[cytopathology]] of asthma is ~~dealth~~ with in ''[[Pulmonary_cytopathology#Asthma\|asthma in pulmonary cytopathology]]''.		The [[cytopathology]] of asthma is dealt with in ''[[Pulmonary_cytopathology#Asthma\|asthma in pulmonary cytopathology]]''.

	==General==		==General==

Michael: split out

2015-03-13T05:31:02Z

split out

← Older revision		Revision as of 05:31, 13 March 2015
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	#~~redirect~~ [[~~Medical_lung_diseases#~~Asthma]]		'''Asthma''' is a common respiratory disease. It occasionally can be fatal and may be seen in the context of [[forensic pathology]].

			The [[cytopathology]] of asthma is dealth with in ''[[Pulmonary_cytopathology#Asthma\|asthma in pulmonary cytopathology]]''.

			==General==
			*The bread and butter of respirology.
			*May be associated with atopy (allergies), medications (e.g. [[NSAID]]s), occupational exposures.<ref name=Ref_PCPBoD8_370>{{Ref PCPBoD8\|370}}</ref>
			*[[Clinical diagnosis]] - diagnosis based on symtpoms/response to therapy<ref name=pmid20176271>{{Cite journal \| last1 = Lemanske \| first1 = RF. \| last2 = Busse \| first2 = WW. \| title = Asthma: clinical expression and molecular mechanisms. \| journal = J Allergy Clin Immunol \| volume = 125 \| issue = 2 Suppl 2 \| pages = S95-102 \| month = Feb \| year = 2010 \| doi = 10.1016/j.jaci.2009.10.047 \| PMID = 20176271 }}</ref> +/-methacholine challenge testing.<ref name=pmid25326695>{{Cite journal \| last1 = Lim \| first1 = SY. \| last2 = Jo \| first2 = YJ. \| last3 = Chun \| first3 = EM. \| title = The correlation between the bronchial hyperresponsiveness to methacholine and asthma like symptoms by GINA questionnaires for the diagnosis of asthma. \| journal = BMC Pulm Med \| volume = 14 \| issue = \| pages = 161 \| month = \| year = 2014 \| doi = 10.1186/1471-2466-14-161 \| PMID = 25326695 }}</ref>

			Treatment:
			*Bronchodilators.
			*+/-Steroids.

			===Pathogenesis===
			*T-cell response T<sub>H</sub>2 dominant.

			Sequence:<ref name=Ref_PCPBoD8_370-2>{{Ref PCPBoD8\|370-2}}</ref>
			*Antigen T<sub>H</sub>2 lymphocyte -> IgE B-cell -> [[mast cell]] IgE Fc -> leukotrienes + other mediators -> bronchospasm, edema, leukocyte recruitment -> airway remodeling.

			==Gross==
			*Lung over-inflation.
			*Mucous plugs.
			*Focal resorption atelectasis,<ref name=Ref_PCPBoD8_363>{{Ref PCPBoD8\|363}}</ref> i.e. collapse.

			==Microscopic==
			Features:<ref name=Ref_Klatt108>{{Ref Klatt\|108}}</ref>
			*Edema.
			*Mucous (plugs).
			*+/-Smooth muscle hypertrophy.
			*+/-Inflammation - especially with [[eosinophil]]s.
			*+/-Charcot-Leyden crystals (formed from eosinophil granules -- breakdown product).
			**Sharp edge, diamond shaped, pink on [[H&E]].

			Notes:
			*''Leyden'' in ''Charcot-Leyden'' is also seen written as ''Leiden''.
			**Finding associated with hypereosinophilia<ref name=pmid6162378>{{Cite journal \| last1 = Dincsoy \| first1 = HP. \| last2 = Burton \| first2 = TJ. \| last3 = van der Bel-Kahn \| first3 = JM. \| title = Circulating Charcot-Leyden crystals in the hypereosinophilic syndrome. \| journal = Am J Clin Pathol \| volume = 75 \| issue = 2 \| pages = 236-43 \| month = Feb \| year = 1981 \| doi = \| PMID = 6162378 }}</ref> - ''not'' pathognomonic for asthma.
			*[[Pulmonary cytopathology]]:
			**''Curschmann's spirals'' = spiral-shaped mucous plugs.<ref name=pmid9812228>{{cite journal \|author=Cenci M, Giovagnoli MR, Alderisio M, Vecchione A \|title=Curschmann's spirals in sputum of subjects exposed daily to urban environmental pollution \|journal=Diagn. Cytopathol. \|volume=19 \|issue=5 \|pages=349–51 \|year=1998 \|month=November \|pmid=9812228 \|doi= \|url=}}</ref>
			**''Creola bodies'' = clusters of (ciliated) bronchial epithelial cells.<ref name=pmid2818212>{{Cite journal \| last1 = Isohima \| first1 = K. \| last2 = Takahashi \| first2 = K. \| last3 = Soda \| first3 = R. \| last4 = Hukasaka \| first4 = N. \| last5 = Tanabe \| first5 = K. \| last6 = Ozaki \| first6 = K. \| last7 = Nakato \| first7 = H. \| last8 = Araki \| first8 = M. \| last9 = Tuzi \| first9 = M. \| title = [The clinical significance of Creola body in the sputum of asthmatic patients]. \| journal = Arerugi \| volume = 38 \| issue = 7 \| pages = 542-8 \| month = Jul \| year = 1989 \| doi = \| PMID = 2818212 }}</ref>

			DDx:
			*Infection - fungal.

			===Images===
			<gallery>
			Image:Charcot-Leyden_crystals,_HE_3.jpg \| Charcot-Leyden crystals. (WC/Patho)
			Image:Charcot-Leyden_crystals,_HE_2.jpg \| Charcot-Leyden crystals. (WC/Patho)
			</gallery>
			www:
			*[http://www.udel.edu/medtech/dlehman/medt372/Ch-lyd.html Charcot-Leyden crystals (udel.edu)].
			*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168024/figure/F1/ Charot-Leyden crystals (nih.gov)].

			==Stains==
			Features - crystals:
			*PAS-D -ve.
			*GMS -ve.

			==Sign out==
			<pre>
			BRONCHIAL CAST, RIGHT LOWER LOBE, REMOVAL:
			- CHARCOT-LEYDEN CRYSTALS.
			- CELLULAR DEBRIS WITH NEUTROPHILS AND ABUNDANT EOSINOPHILS.
			- RESPIRATORY MUCOSA WITH PROMINENT SMOOTH MUSCLE.
			- NEGATIVE FOR MALIGNANCY.

			COMMENT:
			GMS and PAS-D stains are negative for fungal organisms. The findings are non-specific;
			however, they would be compatible with asthma. Clinical and microbiological correlation
			is required.
			</pre>

			==See also==
			*[[Medical lung diseases]].

			==References==
			{{Reflist\|2}}

	[[Category:Diagnosis]]		[[Category:Diagnosis]]
			[[Category:Medical lung diseases]]

Michael: redirect

2011-10-21T04:09:40Z

redirect

← Older revision		Revision as of 04:09, 21 October 2011
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	#redirect [[Medical_lung_diseases#Asthma]]		#redirect [[Medical_lung_diseases#Asthma]]

			[[Category:Diagnosis]]

Michael: redirect for now

2011-01-22T06:38:12Z

redirect for now

New page

#redirect [[Medical_lung_diseases#Asthma]]

Asthma - Revision history

Michael at 05:31, 13 March 2015

Michael at 05:31, 13 March 2015

Michael: split out

Michael: redirect

Michael: redirect for now