Pulmonary Involvement in Mixed Connective Tissue Disease: Comparison With Other Collagen Vascular Diseases Using High Resolution CT

Saito, Yasuharu; Tomita, Masaki; Takada, Toshinori; Ishida, Takashi; Moriyama, Hiroshi; Ooi, Hidemi; Hasegawa, Takashi; Tsukada, Hiroki; Suzuki, Eiichi; Gejyo, Fumitake; Kihara, Yoshinori

doi:10.1097/00004728-200205000-00006

Cited by 63 publications

(29 citation statements)

References 29 publications

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“…ILD is estimated to occur in up to 65% of patients with MCTD [95]; its major histopathological pattern is that of NSIP, as suggested by histological and radiological data [12,22,96]. It typically manifests within the first 2-4 yrs following disease onset, when other systemic manifestations of SLE, SSc or PM are also present as the disease progresses [93,95].…”

Section: Mixed Ctdmentioning

confidence: 99%

“…It typically manifests within the first 2-4 yrs following disease onset, when other systemic manifestations of SLE, SSc or PM are also present as the disease progresses [93,95]. Rarely, the ILD-related symptoms may be the predominant or first manifestation of the disease [96]. In a group of 35 patients with MCTD and ILD undergoing thoracic imaging, SAITO et al [96] reported three patients with only respiratory problems, who were initially believed to have IPF but later diagnosed with MCTD.…”

Section: Mixed Ctdmentioning

confidence: 99%

“…Rarely, the ILD-related symptoms may be the predominant or first manifestation of the disease [96]. In a group of 35 patients with MCTD and ILD undergoing thoracic imaging, SAITO et al [96] reported three patients with only respiratory problems, who were initially believed to have IPF but later diagnosed with MCTD.…”

Section: Mixed Ctdmentioning

confidence: 99%

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Occult connective tissue diseases mimicking idiopathic interstitial pneumonias

Toya²,

2007

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In patients with interstitial lung disease (ILD), the diagnosis of idiopathic interstitial pneumonia is usually made after excluding, among other conditions, connective tissue diseases (CTDs). Although in most patients with a CTD and respiratory symptoms, the systemic nature of the disease is obvious, the ILD-related manifestations in CTDs may often dominate the clinical picture or precede systemic findings and thus mimic idiopathic interstitial pneumonia.With the exception of systemic lupus erythematosus, all CTDs may imitate chronic idiopathic interstitial pneumonias. In this setting, clues to an underlying CTD may be entirely absent or include subtle findings from various systems, including skin, vascular and musculoskeletal system or internal organs. Since nonspecific interstitial pneumonia is a relatively frequent histological pattern in CTDs, biopsy reports of nonspecific interstitial pneumonia should also prompt a search for an underlying CTD.Ultimately, diagnosis of a CTD requires confirmation with immunological testing; interpretation of the various laboratory tests should always be carried out in conjunction with clinical findings.The present article reviews specific clinical aspects of connective tissue disease-related interstitial lung disease that may help differentiate it from idiopathic interstitial pneumonia, especially when interstitial lung disease is the predominant or sole manifestation of an occult connective tissue disease.

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Section: Mixed Ctdmentioning

confidence: 99%

Section: Mixed Ctdmentioning

confidence: 99%

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Occult connective tissue diseases mimicking idiopathic interstitial pneumonias

Toya²,

2007

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“…Patients at risk of developing progressive pulmonary fibrosis are currently identified by the presence of lung inflammation. Lung inflammation is usually demonstrated by an increase in neutrophils or eosinophils on differential cell counts of bronchoalveolar lavage (BAL) fluid (4,5) or by radiographic techniques (6,7). Stratification of patients into risk groups according to the presence of lung inflammation is imprecise; some patients with normal findings on BAL fluid differential cell count experience progressive pulmonary fibrosis, whereas some patients with lung inflammation have stable lung function for several years (4).…”

Section: Group 1 Suggested the Possibility That These T Cells Might Imentioning

confidence: 99%

Occurrence of an activated, profibrotic pattern of gene expression in lung CD8+ T cells from scleroderma patients

Luzina¹,

Atamas²,

Wise³

et al. 2003

Arthritis & Rheumatism

108

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Objective. Pulmonary fibrosis is a major cause of death in scleroderma patients. Previous studies have shown an increase in CD8؉ T cells in the lungs of scleroderma patients. In the present study, we sought to determine whether activated CD8؉ T cells contribute to pulmonary fibrosis in scleroderma patients through the production and activation of profibrotic mediators.Methods. CD8؉ cells were isolated from bronchoalveolar lavage fluid obtained from 19 scleroderma patients and 7 healthy subjects. The phenotype of these cells was determined using DNA array technology. Expression of selected genes was confirmed in real-time polymerase chain reaction and enzyme-linked immunosorbent assay experiments.

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“…Symmetrical ground glass opacity predominantly in the lower lung segments, as in nonspecific interstitial pneumonitis, compatible with the diagnosis of MCTD, was demonstrated ( fig. 1) [10,11].…”

Section: Case Reportmentioning

confidence: 99%

Rapid diagnosis of pulmonary TB by BAL enzyme-linked immunospot assay in an immunocompromised host

Strassburg

Jafari²,

Ernst³

et al. 2008

Eur Respir J

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Immunocompromised patients with acid-fast bacilli (AFB) smear-negative active pulmonary tuberculosis (pTB) often present with nonspecific clinical symptoms and findings. T-cell interferon-c release assays (TIGRA) performed on whole blood (using ELISA) or peripheral blood mononuclear cells (using enzyme-linked immunospot assay (ELISPOT)) are more sensitive for the diagnosis of Mycobacterium tuberculosis (MTB) infection than the tuberculin skin test (TST), but cannot distinguish active from latent MTB infection.The present authors report a 38-yr-old female presenting with a 3-week history of malaise, dyspnoea, fevers and coughing, who had received immunosuppressive therapies over 8 months for mixed connective tissue disease. Chest radiograph and thoracic computed tomography showed ground glass opacities in both lower lobes. The TST-induration was 0 mm and AFBs or MTB nucleic acid was not detected on sputum and bronchial secretions. However, TIGRAs performed on peripheral blood cells were reactive. A high frequency of MTB-specific T-cells compatible with the immunodiagnosis of active pTB was detected among bronchoalveolar lavage cells using ELISPOT. Antituberculous therapy was initiated 18 days before MTB was discovered on sputum cultures.Detection of Mycobacterium tuberculosis-specific T-cells in the bronchoalveolar lavage using enzyme-linked immunospot assay is a promising tool for the diagnosis of active pulmonary tuberculosis in immunocompromised patients with negative acid-fast bacilli smears.

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Pulmonary Involvement in Mixed Connective Tissue Disease: Comparison With Other Collagen Vascular Diseases Using High Resolution CT

Abstract: CT findings in MCTD were a combination of those in other CTDs.

Cited by 63 publications

References 29 publications

Occult connective tissue diseases mimicking idiopathic interstitial pneumonias

Occult connective tissue diseases mimicking idiopathic interstitial pneumonias

Occurrence of an activated, profibrotic pattern of gene expression in lung CD8+ T cells from scleroderma patients

Rapid diagnosis of pulmonary TB by BAL enzyme-linked immunospot assay in an immunocompromised host

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