flu deaths could be due to overactive Immune System.. very interesting..>Link>>

[sam sarrha]

http://www.voanews.com/english/Africa/2009-04-28-voa26.cfm
Moskowitz says the high immune response is caused by what's called a cytokine storm, a "tremendous outpouring of cytokines, of factors released by white cells that get other white cells really jazzed up." He says, "It's these white cells…that basically…turn the lung into a totally cellular organ like a liver, so it can't exchange gas anymore."

..and is misdiagnosed as pneumonia...:shrug:

[Skittles]

1. could a medical DUer explain this in real layman's terms please

I don't understand how an immune system can be "overactive" - I thought it was either good or suppressed

[bobbert]

2. Tell an MS (or Crone's or whatever) patient that their immune system is only good

Overactive immune systems cause all kinds of disorders.

[hedgehog]

3. Well, allergies are a result of an over-reactive immune system.

Histamines are one item in the arsenal the body releases. That's where the runny nose and red eyes come from.


Arthritis: immune system attacking joints

[sam sarrha]

4. it says this is a problem specific to Vitus.. treatment with immune suppressant drugs improves

recovery up to 70%.. virus makes some peoples immune systems go nuts, and it plugs up their lungs an can kill them.. the virus doesn't kill them

[sunwyn]

5. It called a Cytokine storm

Check it out :http://en.wikipedia.org/wiki/Cytokine_storm

[sam sarrha]

8. sounds like Rheumatoid arthritis too.. its a T-cell auto immune disease, i was able to get rid of my...

RA with amino acids Arginine/Ornithine.. it is a fundamental building block of T-cell receptor inhibitors, i was so bad i had to walk with 2 canes... no problems for 30 years now

i get mine at vitamineshoppe.com i only take once a week... or so now, i quit drinking/no sugar/no red meat eat simply, small portions, and do a version of the master cleanser purging fast twice a year

[FourScore]

11. WOW!!! Good for YOU!!!

An inspiration to all!:yourock:

[babydollhead]

17. i love the master cleanse

[Hassin Bin Sober]

7. Here's a link from wiki

I don't lay awake at night worrying about this particular flu but the resemblance is a bit scary - symptoms AND timing (summer outbreak).

http://en.wikipedia.org/wiki/Cytokine_storm

Cytokine storm


Cause
When the immune system is fighting pathogens, cytokines signal immune cells such as T-cells and macrophages to travel to the site of infection. In addition, cytokines activate those cells, stimulating them to produce more cytokines. Normally, this feedback loop is kept in check by the body. However, in some instances, the reaction becomes uncontrolled, and too many immune cells are activated in a single place. The precise reason for this is not entirely understood but may be caused by an exaggerated response when the immune system encounters a new and highly pathogenic invader. Cytokine storms have potential to do significant damage to body tissues and organs. If a cytokine storm occurs in the lungs, for example, fluids and immune cells such as macrophages may accumulate and eventually block off the airways, potentially resulting in death.

The cytokine storm (hypercytokinemia) is the systemic expression of a healthy and vigorous immune system resulting in the release of more than 150 inflammatory mediators (cytokines, oxygen free radicals, and coagulation factors). Both pro-inflammatory cytokines (such as Tumor necrosis factor-alpha, Interleukin-1, and Interleukin-6) and anti-inflammatory cytokines (such as interleukin 10 and interleukin 1 receptor antagonist) are elevated in the serum of patients experiencing a cytokine storm.

Cytokine storms can occur in a number of infectious and non-infectious diseases including graft versus host disease (GVHD), adult respiratory distress syndrome (ARDS), sepsis, avian influenza, smallpox, and systemic inflammatory response syndrome (SIRS).<2>

The first reference to the term cytokine storm in the published medical literature appears to be by Ferrara et al.<3> in GVHD in February 1993.

Role in pandemic deaths
It is believed that cytokine storms were responsible for many of the deaths during the 1918 influenza pandemic, which killed a disproportionate number of young adults.<1> In this case, a healthy immune system may have been a liability rather than an asset. Preliminary research results from Hong Kong also indicated this as the probable reason for many deaths during the SARS epidemic in 2003.<4> Human deaths from the bird flu H5N1 usually involve cytokine storms as well.<5> Recent reports of high mortality among healthy young adults in the 2009 swine flu outbreak point to cytokine storms as being responsible for these deaths.<6><7>

[Creena]

10. I can't explain a cytokine storm, but my mom suffers from MS.

Basically the immune system is so "overactive" that it attacks one's own body. In her case, the body's lymphocytes can't correctly identify foreign viruses and sees the central nervous system as a threat. The description of what specifically is attacked can get rather complicated, so think of it this way...nerves are like electric cords. When they're insulated, electricity is conducted without a problem. Once that insulation is removed, electricity starts arcing. With MS, the immune system basically attacks the body's insulation (myelin sheath) and causes the nerves to short circuit.

[kestrel91316]

12. Autoimmune diseases are one example of an overactive immune system.

So are allergies. Years ago I had a hypersensitivity reaction to a sulfa drug and got in deep serious trouble until we figured out what caused it.

As for cytokine storm, http://en.wikipedia.org/wiki/Cytokine_storm

Or you can find more lay-friendly explanations when you google it. http://www.wisegeek.com/what-is-the-cytokine-storm.htm

[Control-Z]

6. Thanks for the link.

I find it very interesting. If nothing else, we learn some amazing things during a situation like this.

[sam sarrha]

9. and at DU.. wonderful cooperative exchange of information ,

[Control-Z]

15. Indeed. n/t

[bluedawg12]

13. The cytokine storm is thought to lead to ARDS which starts off looking like pneumonia

except that people get very sick very quickly.

[Avalux]

14. What happens in the lungs IS pneumonia.

"Pneumonia" is a general term that means "inflammation of the lungs". The cause of the inflammation, in this case, is not the virus but the body's own white blood cells. They go into a frenzy of sorts in the cells of the lungs, clogging the spacious tissue with fluid so there's no room for air. Respiratory failure follows.

[FedUpWithIt All]

16. Interesting n/t

[Dappleganger]

18. Thank you for posting this good info. nt

[applegrove]

19. That is the case with all flus that kill healthy adults from 20 to 50 years old.

The immune system goes into overdrive. And that drowns the lungs.

[cbc5g]

20. I take immuno-suppressants for crohn's

Along with vaporizing marijuana, I guess I'm safe.


An overactive immune system has caused all the problems in my life pretty much. Skin disorder etc.

[bluedawg12]

21. Explanation of virus related "missed diagnosis," cytokine storm and ARDS.

The reason why viral infections cause death in some healthy patients is that their own immune response creates severe lung inflammation ( the cytokine storm) in response to viral burden and the condition is more severe than common viral pneumonia, the condition is called ARDS.

Here is a quick run down of the difference between various types of lung injuries all the way to ARDS.

In general terms, inflammation of the lungs is called pneumonitis. Pneumonia is a type of pneumonitis. There are other types, such as due to chemical irritants, resulting in chemical induced pneumonitis. (1)

Next, most people are familiar with the term pneumonia which maybe caused by an infection from a variety of causes, “including infection with bacteria, viruses, fungi, or parasites, and chemical or physical injury to the lungs.”(2)

Pneumonia may be serious or mild and is characterized not only by inflammation of the lung tissues, but also leakage of tissue fluid called an exudate, and can “solidify” the lung, called (consolidation and exudation). (2)

In this instance, when discussing the so called cytokine storm and specifically in relationship to respiratory viral infections, the condition may initiate as pneumonia, which is well known and diagnosable, but as the OP stated, that it is a condition that “is misdiagnosed as pneumonia,” then what could be misdiagnosed as pneumonia related to a cytokine storm?

The next level of severity in terms of pulmonary injury is ARDS, which is acute respiratory distress syndrome (ARDS) “a type of severe, acute lung dysfunction affecting all or most of both lungs that occurs as a result of illness or injury. “ (3)

ARDS is associated with cytokine storm and it is deadly.

“Major symptoms (ARDS) may include breathing difficulties (dyspnea), rapid breathing (tachypnea), excessively deep and rapid breathing (hyperventilation) and insufficient levels of oxygen in the circulating blood (hypoxemia). ARDS may develop in conjunction with widespread infection in the body (sepsis) or as a result of pneumonia, trauma, shock, severe burns, aspiration of food into the lung, multiple blood transfusions, and inhalation of toxic fumes, among other things. It usually develops within 24 to 48 hours after the original illness or injury and is considered a medical emergency. It may progress to involvement of other organs.(3)

Cytokine storm is associated with ARDS.


“Transmission of H5N1 to humans is an inefficient process, but once infection is established, the virus replicates rapidly, resulting in high viral burdens in the respiratory tract, and mortality is high.2 Virally infected cells release cytokines and chemokines designed to recruit and shape the innate and adaptive immune responses. In humans, the magnitude of these cytokine and chemokine responses is proportional to the viral burden, which is itself associated with outcome.2 Inflammatory cells infiltrate pulmonary tissues and, together with direct viral-mediated cytopathic effects, create airway congestion, impair gas exchange, and precipitate the acute respiratory distress.” syndrome.

Cytokines are released from lung epithelial cells, activated T-cells and macrophages.

Credit- NEJM




Pneumonia
- credit wikipedia
Top A normal chest x-ray
Bottom B Right lung consolidation and pneumonia.


-credit wikipedia
Acute respiratory distress syndrome
Chest x-ray of typical ARDS patient showing infiltration of both lungs with a white hazy ground glass appearance.


...........

(1) http://www.mayoclinic.com/health/pneumonitis/DS00962/UPDATEAPP=0
Definition
By Mayo Clinic staff


2)http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/six/000084139.htm

3) http://www.webmd.com/a-to-z-guides/acute-respiratory-distress-syndrome

(4) The New England Journal of Medicine
359:1621-1623 October 9, 2008 Number 15
Insights into Inflammation and Influenza
Cameron Simmons, Ph.D., and Jeremy Farrar, M.D., D.Phil.