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Abstract Diffuse interstitial pulmonary fibrosis is defined as a condition of unknown and possibly multiple causation characterized pathologically by a diffuse in:flanunatory process in the lung beyond the terminal bronchioles having its essential features: 1- Cellular thickening of the alveolar wall with a tendency to fibrosis. 2- The presence oflarge mononuclear cells within the alveolar spaces (1 ). In the early stages of diffuse interstitial pulmonary fibrosis Pa 02 may be normal at rest but falls on exercise when the alveolar-arterial oxygen tension gradient is increased. With progression of disease, resting hypoxaemia develops (2). Owing to their active and complex metabolism, liver cells are readily injured by hypoxia (3). The serum levels of glutamic transaminases, lactic dehydrogenase and alkaline phosphatase are raised in patients with COPD (4). Needle liver biopsy performed in patients with COPD and resting hypoxaemia showed focal necrosis and round cell infiltration of the portal tracts (5). |