Pleuro-pulmonary Manifestations of Systemic Lupus Erythematosus: Clinical Features of its Subgroups

Pines, Amos; Kaplinsky, N; Olchovsky, David; Rozenman, Judith; Frankl, O

doi:10.1378/chest.88.1.129

Cited by 99 publications

(46 citation statements)

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“…Although our patients who experienced pulmonary disease did not suffer from complications, pulmonary lupus sometimes carries a serious prognosis. [26] This problem was more frequent in our patients compared with Saudi Arabian, Egyptian, Spanish, and Indian children, [9,12,14,18] but similar to what was seen in children in the UK. [11] Clinically significant renal involvement in systemic lupus erythematosus is more common in children than in adults.…”

Section: Discussionsupporting

confidence: 76%

Juvenile Lupus Erythematosus: Fourteen Years of Experience

et al. 2011

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Amaç: Bu çalışmada Türk çocuklarda juvenil sistemik lupus eritematozusa (JSLE) ilişkin temel klinik ve laboratuvar özellikler ve yanı sıra morbidite ve mortalitenin tanımlanması amaçlandı. Hastalar ve yöntemler:Otuz JSLE'li çocuk (27 kız, 3 erkek; ort. tanı yaşı 12.3 yıl; dağılım 3-16 yıl) retrospektif olarak değerlendirildi. Hastaların hepsi SLE tanısına ilişkin revize edilmiş 1982 Amerikan Romatoloji Birliği kriterlerini karşılamaktaydı ve 16 yaşından önce hastalığın klinik bulgularını sergilemişti. Bulgular: Ortalama takip süresi 2.9 yıl (dağılım 2 ay-10 yıl), tanı öncesi semptomların ortalama süresi ise 3.3 ay (dağılım 2 gün-2 yıl) idi. Hastaların klinik ve laboratuvar özelliklerinin sıklığı şöyle idi: eritematöz malar döküntü 17 (%56), discoid döküntü bir (%3.3), fotosensitivite 16 (%53.3), oral ülser sekiz (%26.7), kas-iskelet tutulumu 26 (%87), serözit 13 (%43), hematolojik anormallikler 21 (%70), renal tutulum 17 (%56), antinükleer antikor pozitifliği 27 (%93), pulmoner tutulum sekiz (%27), kardiyovasküler hastalık yedi (%23) ve merkezi sinir sistemi tutulumu yedi (%23) hastada görüldü. İzlem sırasında üçü böbrek yetmezliğinden, biri sepsisten olmak üzere dört hasta öldü (%13). Çalışma sırasında iki hasta tedavisiz remisyonda, 22 hasta ise tedavi ile remisyonda takip edilmekte idi. İki hasta ise takipten çıkmış idi.Sonuç: Juvenil sistemik lupus eritematozus ciddi, multisistemik bir organ hastalığıdır. JSLE erken tanı ve tedavi ile yüksek bir remisyon oranı sergilemesine karşın, hala önemli bir mortalite oranına sahiptir.Anahtar sözcükler: Juvenil; lupus nefriti; sonuç; sistemik lupus eritematosus; tedavi.Objectives: This study aims to describe the main clinical and laboratory features as well as the morbidity and mortality of juvenile systemic lupus erythematosus (JSLE) in Turkish children. Patients and methods:Thirty children (27 girls, 3 boys; mean age at diagnosis 12.3 years; range 3 to 16 years) with JSLE were evaluated retrospectively. All patients met the 1982 American College of Rheumatology revised criteria for the diagnosis of SLE and had shown clinical manifestations of the disease before the age of 16. Results:The mean period of follow-up was 2.9 years (range 2 months-10 years) and the mean duration of symptoms before diagnosis was 3.3 months (range 2 days-2 years). The frequencies of the clinical and laboratory features of the patients were as follows: erythematous malar rash was seen in 17 (56%), discoid rash in one, photosensitivity in 16 (53.3%), oral ulcers in eight (26.7%), musculoskeletal involvement in 26 (87%), serositis in 13 (43%), hematological abnormalities in 21 (70%), renal involvement in 17 (56%), antinuclearantibody positivity in 27 (93%), pulmonary involvement in eight (27%), cardiovascular disease in seven (23%), and central nervous system involvement in seven patients (23%). During the follow-up four patients (13%) died, three of renal failure and one from sepsis. During the study two patients were in remission without treatment and 22 patients were in remission with treatm...

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Section: Discussionsupporting

confidence: 76%

Juvenile Lupus Erythematosus: Fourteen Years of Experience

et al. 2011

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“…Proces zapalny może obejmować opłucną, drogi oddechowe, miąższ i naczynia płucne oraz mięśnie oddechowe [14]. Najczęściej zajęcie układu oddechowego manifestuje się w postaci zapalenia opłucnej (30-50% chorych) [15]. Znacznie rzadziej stwierdza się zmiany w obrębie miąższu płuc pod postacią ostrego toczniowego zapalenia płuc (acute lupus pneumonitis) i przewlekłego śródmiąższowego włóknienia płuc.…”

Section: Zajęcie Układu Oddechowegounclassified

Wpływ wybranych cytokin na uszkodzenie narządów w toczniu rumieniowatym układowym

Kapłon

Brzosko

2018

Pomeranian J Life Sci

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Systemic lupus erythematosus (SLE) is a rheumatic disease with unclear pathogenesis. In the course of this disease a dysfunction of the immune system occurs, which involves the production of autoantibodies and the deposition of immune complexes, which contributes to the damage of various organs. The most commonly involved organs include: kidneys, skin, joints, the eye, respiratory system, and the cardiovascular and nervous systems, both central and peripheral. In recent years there have been reports regarding the role of cytokines in the pathogenesis of various organs' involvement. However, until now it has not been entirely clear which cytokines are responsible for either the stimulation or inhibition of the inflammatory response, which could be helpful in establishing a relationship with the clinical picture. In this article reports are summarized regarding Interleukins 4, 7, 10, 18 (IL-4, IL-7, IL-10, IL-18) and their relationship with organ involvement in SLE. Interleukin 4 is indicated as a protective cytokine by its role in preventing the development of an autoimmune response. In the case of IL-7, it has a role in increasing the proliferation of autoreactive T-cell clones and the development of the disease. The IL-10, despite its protective effect, is found in patients with SLE at significantly higher concentrations than in the general population and correlates with the SLEDAI disease activity level scale. Interleukin 18 has a pro-inflammatory effect, contributing to damage to tissues and organs. In the serum of patients with SLE significantly higher levels of IL-18 were found than in the control group; there was also a statistically significant positive correlation between serum IL-18 levels and SLEDAI disease activity level scale and anti-dsDNA antibody titers. Increasing levels of serum IL-18 in SLE patients is associated with an increased risk of cardiovascular disease. In addition, IL-18 has an important role in the involvement of the kidneys and skin in SLE patients. Keywords: systemic lupus erythematosus; organ involvement; cytokines. ABSTRAKTToczeń rumieniowaty układowy (TRU) jest chorobą reumatyczną o nie w pełni poznanej patogenezie. W przebiegu tej choroby występuje dysfunkcja układu immunologicznego polegająca na wytwarzaniu autoprzeciwciał i odkładaniu się kompleksów immunologicznych, które przyczyniają się do uszkodzeń różnych narządów. Najczęściej zajęte narządy to: nerki, skóra, układ ruchu, narząd wzroku, układ oddechowy, układ sercowo--naczyniowy oraz nerwowy, zarówno ośrodkowy, jak i obwodowy. W ostatnich latach pojawiły się doniesienia dotyczące roli cytokin w patogenezie zajęcia różnych narządów. Jednakże do tej pory nie jest w pełni jasne, które cytokiny są odpowiedzialne za nasilenie, a które za zmniejszenie odpowiedzi zapalnej, co mogłoby pomóc w ustaleniu związku z obrazem klinicznym. W artykule zestawione zostały doniesienia dotyczące Interleukin (IL) 4, 7, 10, 18 oraz ich związku z zajęciem narządowym w przebiegu TRU. W przypadku IL-4 wskazuje się na ochronną rolę tej cyt...

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“…A lupusos betegek általános pulmonológiai vizsgálata során gyakorta, több mint 50%-ban észlelhető pulmonalis manifesztáció [1]. Leggyakrabban a diffúziós kapacitás (DL CO ) csökkenése észlelhető, amely restriktív ventilációs zavarral járhat együtt [2,3].…”

Section: öSszefoglaló Közleményunclassified

A szisztémás lupus erythematosus pulmonalis manifesztációi

2016

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A kötőszöveti betegségek tekintetében a pulmonalis manifesztáció megjelenése szisztémás lupus erythematosusban az egyik leggyakoribb. Lupusban bármely szervrendszer érintett lehet, mégis a tüdőérintettség az esetek döntő több-ségében kialakul, és jelentős hatással van a betegség lefolyására. Szisztémás lupus erythematosusban a pulmonalis manifesztációkat az anatómiai érintettség alapján öt csoportba lehet sorolni: pleura, tüdőparenchyma, bronchusok és bronchiolusok, pulmonalis vasculatura, illetve a légzőizmok érintettsége. A leggyakoribb pulmonalis érintettség a pleuritis, amely pleuralis folyadékkal vagy a nélkül is előfordulhat, gyakori a pulmonalis vascularis és a felső és alsó légúti érintettség, a tüdőparenchyma-eltérések és a diaphragmadiszfunkció (shrinking lung szindróma). A szerzők a közlemény kapcsán a lupusban szenvedő betegek pulmonalis eltéréseire, ezek diagnosztikájára, a kezelésükre és a prognózisra szeretnék felhívni a figyelmet. Orv. Hetil., 2016, 157(29), 1154-1160.Kulcsszavak: SLE, pulmonalis érintettség, pleuritis, pulmonalis hypertonia, shrinking lung szindróma Pulmonary manifestations in systemic lupus erythematosusSystemic lupus erythematosus is the most common connective tissue disease that is associated with pulmonary manifestations. Although lupus has the potential to affect any organ, lung involvement is observed during the course of the disease in most cases and it is prognostic for outcome. Pulmonary manifestations in lupus can be classified into five groups based on the anatomical involvement: pleura, lung parenchyma, bronchi and bronchioli, lung vasculature and respiratory muscles can be involved. The most common respiratory manifestations attributable to lupus are pleuritis with or without pleural effusion, pulmonary vascular disease, upper and lower airway dysfunction, parenchymal disease, and diaphragmatic dysfunction (shrinking lung syndrome). In this article the authors summarize lung involvement of lupus, its diagnosis, therapy and prognosis. Rövidítések 6MWT = (6-minute-walk test) 6 perces járásteszt; ACR = (American College of Rheumatology) Amerikai Reumatológiai Kollégium; ANA = antinukleáris antitest; COPD = krónikus obstruktív tüdőbetegség; DAD = (diffuse alveolar damage) diffúz alveolaris károsodás; DL CO = szén-monoxid diffúziós kapacitás; FEV 1 = erőltetett kilégzési másodperctérfogat; FVC = forszírozott vitálkapacitás; GGO = (ground glass opacity) tejüveghomály; HRCT = nagy felbontású CT-vizsgálat; IgG = immunglobulin G; IgM = immunglobulin M; ILD = (interstitial lung disease) interstitialis tüdőbetegség; INR = nemzetközi normalizált ráta; IVIG = intravénás immunglobulin; LDH = laktátdehidrogenáz; LIP = lymphoid interstitialis pneumonia; NSIP = nem specifikus interstitialis pneumonia; OP = organizáló pneumonia; RA = rheumatoid arthritis; RNP = ribonukleoprotein; SLE = szisztémás lupus erythematosus; SLICC = (Systemic Lupus International Collaborating Clinics) Sziszté-más lupus nemzetközi kollaborációs klinikai kritériumok; SLS = (shrinking lung syndrome) zsugorodó t...

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Pleuro-pulmonary Manifestations of Systemic Lupus Erythematosus: Clinical Features of its Subgroups

Cited by 99 publications

References 48 publications

Juvenile Lupus Erythematosus: Fourteen Years of Experience

Juvenile Lupus Erythematosus: Fourteen Years of Experience

Wpływ wybranych cytokin na uszkodzenie narządów w toczniu rumieniowatym układowym

A szisztémás lupus erythematosus pulmonalis manifesztációi

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