title: The role of anti-epithelial cell antibodies in the pathogenesis of bilateral radiation pneumonitis caused by unilateral thoracic irradiation.
abstract: Two cases of bilateral radiation pneumonitis associated with unilateral thoracic irradiation against lung cancer are described. Both patients died of respiratory failure and autopsy was performed. Histologically, bilateral diffuse alveolar damage was demonstrated in both cases, associated with marked organization of hyaline membrane in one case (case 1). In addition, numerous hyperplastic type II pneumocytes which strongly expressed cytokeratins 8, 18 and 19 were observed. In both patients' sera, antibodies against cytokeratin 8, 18 and 19 were demonstrated by a Western immunoblot. The possible association between autoantibodies to cytokeratins and diffuse alveolar damage observed in patients with bilateral radiation pneumonitis are discussed.
authors.affiliation: First Department of Internal Medicine, Kagawa Medical University, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Fujita
authors.forename: S
authors.initials: S
authors.lastname: Bandoh
authors.forename: Y
authors.initials: Y
authors.lastname: Ohtsuki
authors.forename: N
authors.initials: N
authors.lastname: Dobashi
authors.forename: M
authors.initials: M
authors.lastname: Hiroi
authors.forename: T
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Fukunaga
authors.forename: H
authors.initials: H
authors.lastname: Miyaue
authors.forename: S
authors.initials: S
authors.lastname: Onishi
authors.forename: T
authors.initials: T
authors.lastname: Ishida
authors.forename: J
authors.initials: J
authors.lastname: Takahara
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy*; D000368:Aged; D001323:Autoantibodies / Q000276:immunology*; D015153:Blotting, Western / Q000379:methods; D017809:Fatal Outcome; D006801:Humans; D007633:Keratins / Q000037:antagonists & inhibitors* / Q000276:immunology; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D011650:Pulmonary Alveoli / Q000276:immunology; D017564:Radiation Pneumonitis / Q000276:immunology*; D018228:Sarcoma, Small Cell / Q000532:radiotherapy*
chemical_list: D001323:Autoantibodies; D007633:Keratins