Aneurysm of the Pulmonary Artery Due to Schistosomiasis

Zaky, H. A.

doi:10.1378/chest.21.2.194

Cited by 19 publications

(9 citation statements)

References 3 publications

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“…Pulmonary artery aneurysm is an exceedingly rare finding, but since the first report of schistosomal pulmonary artery aneurysm by Dr. Halim Zaky from Egypt in 1952 [8], another case from Brasil was reported by Piveta et al in 2012 [9]. Both of these reports directly attribute pulmonary artery aneurysm to Schistosoma mansoni parasitic infestation.…”

Section: Discussionmentioning

confidence: 99%

“…The collateral circulation (porto-caval anastomosis) produced by portal hypertension in cases with hepatosplenic schistosomiasis is essential to divert the schistosome and its ova from the portal to the pulmonary vasculature [7,8]. Multiple microembolizations of schistosome eggs produce chronic granulomatous inflammation in and around the pulmonary arterioles, leading to pulmonary hypertension and consequent right ventricular dilatation (cor-pulmonale) [11].…”

Section: Discussionmentioning

confidence: 99%

“…Most probably, the impact of schistosome-induced damage upon the walls of the main pulmonary arteries was more severe relative to the other segments of the pulmonary circulation, resulting in the formation of pulmonary artery aneurysm. In this respect, obliterative endarteritis in the vasa vasorum of the large pulmonary arteries in cases of pulmonary schistosomiasis has been reported to weaken their walls, leading to dilatation even in the absence of pulmonary hypertension [8]. Interestingly, the same mechanism was specified in the first reported case of schistosomal aortic aneurysm, where an extensive infestation of the left upper lobe by ova of Schistosoma mansoni caused extension of the disease into the adjacent pleura and aortic sheath, producing endarteritis obliterans of the vasa vasorum of the aorta and subsequent formation of an aortic aneurysm in the absence of systemic hypertension [12].…”

Section: Discussionmentioning

confidence: 99%

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A Huge Thrombosed Pulmonary Artery Aneurysm without Pulmonary Hypertension in a Patient with Hepatosplenic Schistosomiasis

Ramadan

2015

Am J Case Rep

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Patient: Male, 55Final Diagnosis: Thrombosed pulmonary artery aneurysmSymptoms: Cough productive • fever • shortness of breathMedication: —Clinical Procedure: PericardiocentesisSpecialty: CardiologyObjective:Rare diseaseBackground:We herein report a case of huge pulmonary artery aneurysm in a 55-year-old male farmer from the Nile delta (Lower-Egypt), mostly due to infestation with Schistosoma mansoni, which is the parasite causing hepatosplenic schistosomiasis.Case Report:This male patient was admitted with a month-long history of progressive shortness of breath, 2-month history of fever, and a cough with mucoid sputum for 10 days. On examination, he had normal temperature and blood pressure, but he had tachypnea, tachycardia, and congested neck veins. Electrocardiography showed multifocal atrial tachycardia and right bundle branch block.Conclusions:The present case is unique in that it shows the presence of a huge pulmonary artery aneurysm despite the absence of pulmonary hypertension.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Huge Thrombosed Pulmonary Artery Aneurysm without Pulmonary Hypertension in a Patient with Hepatosplenic Schistosomiasis

Ramadan

2015

Am J Case Rep

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“…We are indebted to the staff of the Department of Respiratory Physiology for carrying out the investigations described in this reportPorto-pulmonary bilharziasis often presents as hepatosplenomegaly and cor pulmonale (Zaky, 1952 ; Zaky et al, 1959). The haemodynamic changes in this disease have already been discussed (Foda, 1959; Zaky et al, 1962).…”

Section: Brits 1021mentioning

confidence: 99%

“…The inhalation of isoprenaline in combination with atropine methonitrate showed substantial advantages over the other drugs tested. At 15 minutes the response was as good as the best isoprenaline response; it continued to improve for 120 minutes, after which it was maintained at this level during the three and a half hours of observation.It is recommended that the frequency of administration of atropine methonitrate with or without adrenergic inhalants should be strictly controlled, especially in acute asthma.We are indebted to the staff of the Department of Respiratory Physiology for carrying out the investigations described in this reportPorto-pulmonary bilharziasis often presents as hepatosplenomegaly and cor pulmonale (Zaky, 1952 ; Zaky et al, 1959). The haemodynamic changes in this disease have already been discussed (Foda, 1959; Zaky et al, 1962).…”

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confidence: 99%

Use of Krypton-85 in the Study of Hypoxia in Porto-pulmonary Bilharziasis (Schistosomiasis)

Zaky¹,

El-Heneidy²,

Khalil³

1964

BMJ

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BRITS 1021observations it was found that the immediate effect of the adrenergic drugs was similar.To obtain a measure of the duration of effect of the different inhalants, serial assessments were continued for three and a half hours after each inhalant therapy on two groups of asthmatic subjects containing 12 subjects in each group. From these serial studies it was found that the inhalants gave distinct time-response curves.The duration of isoprenaline was shortest; its action had been completely lost by 90 Porto-pulmonary bilharziasis often presents as hepatosplenomegaly and cor pulmonale (Zaky, 1952 ; Zaky et al., 1959). The haemodynamic changes in this disease have already been discussed Zaky et al., 1962). We found that in about 10% of these cases hypoxia of less than 94% was present. This hypoxia could not be corrected by 100% 02 inhalation.When the alveolar CO2 tension was matched simultaneously against the arterial CO2 tension either at rest or on moderate exercise, a significant gradient was found between the alveolar Pco2 and the arterial Pco2, the latter being raised from 2 to 7 mm. Hg. Studies of pulmonary function in these cases revealed almost normal findings (Ashba, 1959), particularly the minute alveolar ventilation and the helium-mixing time. These findings can only mean a veno-arterial admixture either inside the lung from pre-capillary pulmonary-artery/pulmonary-vein shunting or from the portal-vein blood to the pulmonary vein. In order to elucidate the above findings it was decided to carry out further investigations using the gas krypton-85. Materials and MethodsKrypton-85 is a very interesting gas in that it is cleared by the alveoli to the extent of 95-99% in one circulation. We followed the method described by Fritts et al. (1960) to investigate the problem of a pre-capillary pulmonary-artery/ pulmonary-vein shunting. By this method a gas solute is injected with a known quantity of a blue dye into the superior vena cava and both are recovered from the brachial artery within the period of one circulation. The concentration of dye is obtained from spectrophotometer readings, while the radioactivity is read on the scaler. The percentage of shunt is calculated from the formula: 85Kr counts in integrated radialxconc. of dye injected mg.11. x100 85Kr counts injected x conc. of dye in integrated radial mg./I.The pulmonary-artery concentrations after injection into the superior vena cava were calculated from the radiological size of the heart after the method of Hanson (1961), and the ratio of the right to the left cavities was considered to be 55-45%. This gave the cardiac volume in which the dilution of superiorvena-cava injection could have taken place.To investigate the problem of portal-vein/pulmonary-vein shunting, the same amount of krypton-85 was injected into the splenic pulp in bolus form; the bilharzial spleen lends itself admirably for the purpose as it is easily accessible and firm. We had no trouble while using this route in our case apart from a moderate degree of pain after the...

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