Influence of Interstitial Lung Disease on Outcome in Systemic Sclerosis

Bauer, Philippe R.; Schiavo, Dante; Osborn, Thomas G.; Levin, David L.; Sauver, Jennifer L. St.; Hanson, Andrew C.; Schroeder, Darrell R.; Ryu, Jay H.

doi:10.1378/chest.12-2768

Cited by 32 publications

(28 citation statements)

References 29 publications

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“…airway illness due to bronco‐aspiration that is secondary to gastro‐oesophageal reflux, toxicity due to medications, and infections, among others) . The presence of parenchymal lung disease (HR = 2.9, P = 0.023), pulmonary hypertension (HR = 4.78, P = 0.002) and renal disease (HR = 2.78, P = 0.016) is associated with increased mortality in patients with SS in the nontransplant setting. The presence of ILD or PH is responsible for 60% of the mortality in these patients .…”

Section: Discussionmentioning

confidence: 99%

“…The presence of parenchymal lung disease (HR = 2.9, P = 0.023), pulmonary hypertension (HR = 4.78, P = 0.002) and renal disease (HR = 2.78, P = 0.016) is associated with increased mortality in patients with SS in the nontransplant setting. The presence of ILD or PH is responsible for 60% of the mortality in these patients . According to our findings, in the transplant setting, pulmonary involvement seems to have the same impact on mortality.…”

Section: Discussionmentioning

confidence: 99%

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Kidney transplantation in patients with systemic sclerosis: a nationwide multicentre study

et al. 2017

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Kidney transplantation is one of the therapeutic options for end-stage renal disease (ESRD) in systemic sclerosis (SS). Current evidence demonstrates poorer patient and graft survival after transplantation in SS than in other primary kidney diseases. All the patients presenting ESRD associated with SS who had received a kidney allograft between 1987 and 2013 were systematically included from 20 French kidney transplantation centres. Thirty-four patients received 36 kidney transplants during the study period. Initial kidney disease was scleroderma renal crisis in 76.4%. Extrarenal involvement of SS was generally stable, except cardiac and gastrointestinal involvements, which worsened after kidney transplantation in 45% and 26% of cases, respectively. Patient survival was 100%, 90.3% and 82.5% at 1, 3 and 5 years post-transplant, respectively. Pulmonary involvement of SS was an independent risk factor of death after transplantation. Death-censored graft survival was 97.2% after 1 and 3 years, and 92.8% after 5 years. Recurrence of scleroderma renal crisis was diagnosed in three cases. In our study, patient and graft survivals after kidney transplantation can be considered as excellent. On this basis, we propose that in the absence of extrarenal contraindication, SS patients presenting with ESRD should be considered for kidney transplantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Kidney transplantation in patients with systemic sclerosis: a nationwide multicentre study

et al. 2017

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“…In contrast to the formerly mentioned t-RNA-synthetase antibodies and SSA/SSB antibodies it is unlikely to find SSc-specific auto-antibodies in the presence of a negative ANA-test. Interstitial lung disease is a complication observed relatively late in the course of the disease and hardly as first or lone manifestation [110,111]. Screening for anti-topo-I, Th/To, RNA-polymearse III and CENP-B therefore may be performed just in case of a positive ANAtest and typical clinical signs and symptoms of systemic sclerosis.…”

Section: Topoisomerase I (Topo I/scl-70) Rna Polymerase Iii Th/to Amentioning

confidence: 99%

The use of auto-antibody testing in the evaluation of interstitial lung disease (ILD) – A practical approach for the pulmonologist

Bahmer

Romagnoli

Girelli

et al. 2016

Respiratory Medicine

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Interstitial lung diseases (ILD), also defined as diffuse parenchymal lung diseases (DPLD) include a heterogeneous group of pulmonary disorders. They may be caused by an underlying connective tissue disease (CTD), Rheumatoid Arthritis (RA) or ANCA-associated Vasculitis (AAV). Pulmonary manifestations of these conditions may also precede systemic onset and therefore, pulmonologists may be confronted with diagnosing a systemic rheumatic disease. For the discrimination of CTD-related ILD and idiopathic interstitial pneumonia (IIP), serological testing is recommended. After careful reviewing the available literature, we suggest a serologic diagnostic algorithm for pulmonologists dealing with ILD-patients. This algorithm depicts the consensus for antibody testing that was reached amongst authors. Obviously this consensus approach requires further validation in everyday practice and leaves room for local adaption of the diagnostic strategy depending on the availability of diagnostic capacity and cost. It is our hope, however, that the rational and stepwise approach of serological testing for ILD will ultimately save unnecessary expenses associated with general laboratory screening. Finally a broader consensus on the strategy for laboratory testing in ILD in general might also improve the detection level of these relatively rare diseases and this will ultimately improve management and care of patients suffering from these complex disorders.

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“…Systemic sclerosis (SSc) is characterized by small vessel vasculopathy, production of autoantibodies and fibroblast dysfunction increasing the deposition of extracellular matrix . Interstitial lung disease (ILD) is a common complication of SSc with a reported prevalence of 25–90% according to a previous review, and it is evidently associated with an increased risk of death …”

Section: Introductionmentioning

confidence: 99%

Radiographic fibrosis score predicts survival in systemic sclerosis‐associated interstitial lung disease

et al. 2017

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Influence of Interstitial Lung Disease on Outcome in Systemic Sclerosis

Abstract: Abbreviations: ACR 5 American College of Rheumatology; CHF 5 congestive heart failure; CKD 5 chronic kidney disease; ILD 5 interstitial lung disease; IQR 5 interquartile range; PAH 5 pulmonary arterial hypertension; REP 5 Rochester Epidemiology Project; SSc 5 systemic sclerosis

Cited by 32 publications

References 29 publications

Kidney transplantation in patients with systemic sclerosis: a nationwide multicentre study

Kidney transplantation in patients with systemic sclerosis: a nationwide multicentre study

The use of auto-antibody testing in the evaluation of interstitial lung disease (ILD) – A practical approach for the pulmonologist

Radiographic fibrosis score predicts survival in systemic sclerosis‐associated interstitial lung disease

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