摘要:

The respiratory system is affected more commonly in systemic lupus erythematosus (SLE) than in any other collagen vascular disease. In this article the many different manifestations of SLE in the pleura, lung parenchyma, lung vasculature, upper and lower airways, and respiratory muscles are reviewed: Moreover, indirect involvement of the respiratory system with SLE is discussed with special reference to pulmonary infection and drug-induced SLE pulmonary disease.

ISSN:0883-5993    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The concardiac manifestations of rheumatoid arthritis (RA) in the thorax are complex and varied. The bony thorax, pleura, lung parenchyma; tracheobronchial tree, larynx, and upper airway can all be sites of disease. Drug therapy for RA can result in thoracic disease that is difficult to distinguish from the manifestations of RA itself. This article reviews the available literature pertinent to noncardiac thoracic manifestations of RA and focuses on clinical and radiographic presentations in order to provide an organized approach to patient care.

ISSN:0883-5993    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Scleroderma is a severe systemic collagen vascular disease of unknown cause characterized by marked vascular and connective tissue abnormalities. The lungs are commonly involved in scleroderma, ranking only behind the skin, the peripheral vasculature, and the esophagus in frequency of organ involvement. Respiratory symptoms are, in a very few cases, the presenting manifestation of the disease. Abnormalities of pulmonary function in affected patients include a restrictive ventilatory defect, air flow obstruction, and a depressed diffusing capacity for carbon monoxide, which may be an isolated early finding. Interstitial lung disease and honeycombed lung are the most common pulmonary parenchymal abnormalities seen on chest radiographs. Enlargement of the cardiac silhouette and pulmonary artery due to scleroderma-induced pulmonary vascular disease is also noted. High-resolution computed tomography (HRCT) apparently is a sensitive, potentially useful technique for detecting occult interstitial lung disease in patients with scleroderma. Bronchoalveolar lavage usually shows an increase in total cell count and in the percentage of granulocytes; occasionally, there is a predominantly mononuclear (lymphocytic) cell alveolitis. Premortem and postmortem studies reveal two predominant lung lesions: (1) interstitial lung disease and (2) pulmonary vascular disease. Pulmonary vascular disease may occur in the absence of interstitial lung disease, particularly in patients with limited, as opposed to diffuse, scleroderma. The overall mortality rate in scleroderma is 50% at 7 years, and pulmonary complications are the major cause of death. No prospective, well-controlled studies have established that treatment alters the natural course of pulmonary disease in patients with scleroderma. Both D-penicillamine and cyclophosphamide have shown promise for treating patients with interstitial lung disease, and nifedipine may be useful for treating patients with early pulmonary vascular disease.

ISSN:0883-5993    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Polymyositis-dermatomyositis (PM-DM) is an inflammatory disease of muscle and skin mediated by autoimmune and cellular events. Most typically, muscle weakness is the usual presentation. This review emphasizes that often the systemic components of this disease may mask the usual presentation and actually may be the presenting and only manifestations; more often than not they are the causes of increased morbidity and mortality. In particular, the cardiopulmonary manifestations may dominate the disease course. Cardiac complications include congestive heart failure resulting from a primary cardiomyopathy, disrhythmias and atrioventricular conduction disturbances, sick sinus syndrome, and cor pulmonale either secondary to interstitial lung disease (JLD) or primary pulmonary artery hypertension. Recurrent aspiration pneumonia results from pharyngeal muscle involvement by the myositic process. Several histologic patterns of ILD can emerge with varying outcomes and responses to immunosuppressive therapy. Involvement of the muscles of respiration can lead to hypercapnic respiratory failure, diaphragmatic dysfunction, hypostatic pneumonia, and restrictive lung disease.

ISSN:0883-5993    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Patients with mixed connective tissue disease (MCTD) exhibit clinical features of systemic lupus erythematosus (SLE), progressive systemic sclerosis or scleroderma (PSS), and polymyositis-dermatomyositis (PM-DM). In their sera is an unusually high titer of a circulating antinuclear antibody with specificity for a nuclear ribonucleoprotein antigen. Pleuropulmonary manifestations are common in MCTD and the incidence varies from 20% to 85%. The pleuropulmonary complications include pleural effusion, intersitial pulmonary processes, pulmonary arterial hypertension (PAH), pulmonary vasculitis, pulmonary thromboembolic phenomena, aspiration pneumonia, and hypoventilatory failure. Pulmonary vascular pathology with progressive PAH and cor pulmonale is the most serious complication of MCTD. The pleuropulmonary manifestations in MCTD are similar to the respiratory problems well recorded in SLE, PSS, and PM-DM. Even though the pleuropulmonary complications are common in MCTD, they may remain clinically inapparent until fatal complications ensure.

ISSN:0883-5993    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The pulmonary manifestations of collagen vascular diseases span an enormous range of clinical and radiographic findings. The breadth of these abnormalities is as diverse as the underlying diseases themselves. A comprehensive discussion of pulmonary involvement in four of these diseases, the Marfan syndrome, ankylosing spondylitis, Sjögren's syndrome, and relapsing polychondritis, is presented.

ISSN:0883-5993    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0883-5993    

出版商:OVID    

年代:1992

数据来源: OVID