Infliximab (Remicade), a chimeric monoclonal antibody to tumor necrosis factor-alpha (anti-TNF-alpha), is being used with increasing frequency in the treatment of Crohn's disease. Infliximab's safety profile to date has been good with reported adverse events being mild to moderate. We report a case of diffuse alveolar hemorrhage after the second infliximab infusion in a patient with Crohn's disease. The mechanism by which infliximab may have caused the observed pulmonary insult remains unknown. Physicians should be aware of the possible association between infliximab treatment and the development of alveolar hemorrhage. Future cases should be reported.
We describe the technique for the first robotically assisted bilateral bronchoplasty for the treatment of tracheobronchomalacia. Since 1954, this disease process has been treated with a right thoracotomy and posterior splinting of the tracheal membrane with mesh to restore the C-shape of the trachea. Traditional video-assisted thoracoscopic surgery has been of limited benefit in these cases owing to technical challenges. A robotically assisted technique offers the dual benefit of a minimally invasive port-based system while reproducing an open surgical technique.
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