Interstitial pulmonary fibrosis is described in a 26-year-old woman with malignant lymphoma after prolonged intake of cyclophosphamide. Cyclophosphamide was given over a period of 13 years in an oral daily dose of 50 100 mg. Lung biopsy revealed extensive fibrosis with no evidence of malignancy or infection. Cyclophosphamide is considered the most likely cause of pulmonary fibrosis in this patient.
Steady-state CO pulmonary diffusing capacity (DLCO) was measured at different inspired CO concentrations in seven males and one female during light treadmill exercise. As the CO level is increased. DLCO increases, reaches a maximum at an end-tidal CO concentration of approximately 100 ppm, and then decreases. The maximum DLCO is up to twice as large as the DLCO measured at an inspired CO concentration of approximately 1,780 ppm. These results are consistent with the presence of saturation kinetics, one of the basic properties of carrier-mediated transport systems. A similar relationship between DLCO and CO concentration was found in previous studies of mechanically ventilated dogs. Thus there is evidence for carrier-mediated transport of CO in the lungs of both humans and dogs.
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