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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Budapest, Diós árok u. 1/C, 1125
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Absztrakt

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 többségében 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.

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  • 1

    Pines, A., Kaplinsky, N., Olchovsky, D., et al.: Pleuro-pulmonary manifestations of systemic lupus erythematosus: clinical features of its subgroups. Prognostic and therapeutic implications. Chest, 1985, 88(1), 129–135.

  • 2

    Andonopoulos, A. P., Constantopoulos, S. H., Galanopoulou, V., et al.: Pulmonary function of nonsmoking patients with systemic lupus erythematosus. Chest, 1988, 94(2), 312–315.

  • 3

    Traynor, A. E., Corbridge, T. C., Eagan, A. E., et al.: Prevalence and reversibility of pulmonary dysfunction in refractory systemic lupus: improvement correlates with disease remission following haemopoetic stem cell transplantation. Chest, 2005, 127(5), 1680–1689.

  • 4

    Vincze, K., Kovats, Zs., Cseh, A., et al.: Peripheral CD4+ cell prevalence and pleuropulmonary manifestations in systemic lupus erythematosus patients. Respir. Med., 2014, 108(5), 766–774.

  • 5

    Petri, M., Orbai, A. M., Alarcón, G. S., et al.: Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum., 2012, 64(8), 2677–2686.

  • 6

    Swigris, J. J., Fischer, A., Gillis, J., et al.: Pulmonary and thrombotic manifestations of systemic lupus erythematosus. Chest, 2008, 133(1), 271–280.

  • 7

    Mittoo, S., Gelber, A. C., Hitchon, C. A., et al.: Clinical and serologic factors associated with lupus pleuritis. J. Rheumatol., 2010, 37(4), 747–753.

  • 8

    Badui, E., Garcia-Rubi, D., Robles, E., et al.: Cardiovascular manifestations in systemic lupus erythematosus. Prospective study of 100 patients. Angiology, 1985, 36(7), 431–441.

  • 9

    Toworakul, C., Kasitanon, N., Sukitawut, W., et al.: Usefulness of pleural effusion antinuclear antibodies in the diagnosis of lupus pleuritis. Lupus, 2011, 20(10), 1042–1046.

  • 10

    Winslow, W. A., Ploss, L. N., Loitman, B.: Pleuritis in systemic lupus erythematosus: its importance as an early manifestation in diagnosis. Ann. Intern. Med., 1958, 49(1), 70–88.

  • 11

    Glazer, M., Berkman, N., Lafair, J. S., et al.: Successful talc slurry pleurodesis in patients with nonmalignant pleural effusion. Chest, 2000, 117(5), 1404–1409.

  • 12

    Dhala, A.: Pulmonary arterial hypertension in systemic lupus erythematosus: current status and future direction. Clin. Dev. Immunol., 2012, 2012, 854941.

  • 13

    Badesch, D. B., Abman, S. H., Ahearn, G. S., et al.: Medical therapy for pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest, 2004, 126(1 Suppl.), 35S–62S.

  • 14

    Lian, F., Chen, D., Wang, Y., et al.: Clinical features and independent predictors of pulmonary arterial hypertension in systemic lupus erythematosus. Rheumatol. Int., 2012, 32(6), 1727–1731.

  • 15

    Robbins, I. M., Gaine, S. P., Schilz, R., et al.: Epoprostenol for treatment of pulmonary hypertension in patients with systemic lupus erythematosus. Chest, 2000, 117(1), 14–18.

  • 16

    Cozzi, F., Montisci, R., Marotta, H., et al.: Bosentan therapy of pulmonary arterial hypertension in connective tissue diseases. Eur. J. Clin. Invest., 2006, 36(Suppl. 3), 49–53.

  • 17

    Barst, R. J., Langleben, D., Frost, A., et al.: Sitaxsentan therapy for pulmonary arterial hypertension. Am. J. Respir. Crit. Care Med., 2004, 169(4), 441–447.

  • 18

    Wilkins, M. R., Paul, G. A., Strange, J. W., et al.: Sildenafil versus endothelin receptor antagonist for pulmonary hypertension (SERAPH) study. Am. J. Respir. Crit. Care Med., 2005, 171(11), 1292–1297.

  • 19

    Highland, K.: Pulmonary hypertension in systemic lupus erythematosus. Pulm. Hypertens. J., 2008, 7(2).

  • 20

    Belmont, H. M., Buyon, J., Giorno, R., et al.: Up-regulation of endothelial cell adhesion molecules characterizes disease activity in systemic lupus erythematosus. The Shwartzman phenomenon revisited. Arthritis Rheum., 1994, 37(3), 376–383.

  • 21

    Abramson, S. B., Dobro, J., Eberle, M. A., et al.: Acute reversible hypoxaemia in systemic lupus erythematosus. Ann. Intern. Med., 1991, 114(11), 941–947.

  • 22

    Keane, M. P., Lynch, J. P. 3rd.: Pleuropulmonary manifestations of systemic lupus erythematosus. Thorax, 2000, 55(2), 159–166.

  • 23

    Barile-Fabris, L., Hernández-Cabrera, M. F., Barragan-Garfias, J. A.: Vasculitis in systemic lupus erythematosus. Curr. Rheumatol. Rep., 2014, 16(9), 440.

  • 24

    Asherson, R. A., Oakley, C. M.: Pulmonary hypertension and systemic lupus erythematosus. J. Rheumatol., 1986, 13(1), 1–5.

  • 25

    Brown, K. K.: Pulmonary vasculitis. Proc. Am. Thorac. Soc., 2006, 3(1), 48–57.

  • 26

    Schwarz, M. I., Brown, K. K.: Small vessel vasculitis of the lung. Thorax, 2000, 55(6), 502–510.

  • 27

    Jayne, D.: Evidence-based treatment of systemic vasculitis. Rheumatology (Oxford), 2000, 39(6), 585–595.

  • 28

    Aviña-Zubieta, J. A., Vostretsova, K., De Vera, M. A., et al.: The risk of pulmonary embolism and deep venous thrombosis in systemic lupus erythematosus: a general population-based study. Semin. Arthritis Rheum., 2015, 45(2), 195–201.

  • 29

    Espinosa, G., Cervera, R., Font, J., et al.: The lung in the antiphospholipid syndrome. Ann. Rheum. Dis., 2002, 61(3), 195–198.

  • 30

    Karim, A., Ahmed, S., Siddiqui, R., et al.: Severe upper airway obstruction from cricoarytenoiditis as the sole presenting manifestation of a systemic lupus erythematosus flare. Chest, 2002, 121(3), 990–993.

  • 31

    Kinney, W. W., Angelillo, V. A.: Bronchiolitis in systemic lupus erythematosus. Chest, 1982, 82(5), 646–649.

  • 32

    Shen, T. C., Lin, C. H., Chen, C. H., et al.: Increased risk of chronic obstructive pulmonary disease in patients with systemic lupus erythematosus: a population-based cohort study. PLoS ONE, 2014, 9(3), e91821.

  • 33

    Antoniou, K. M., Margaritopoulos, G., Economidou, F., et al.: Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement. Eur. Respir. J., 2009, 33(4), 882–896.

  • 34

    Chattopadhyay, B., Chatterjee, A., Maiti, A., et al.: Systemic lupus erythematosus presenting as acute lupus pneumonitis in a young female. J. Postgrad. Med., 2015, 61(2), 129–130.

  • 35

    Cheema, G. S., Quismorio, F. P. Jr.: Interstitial lung disease in systemic lupus erythematosus. Curr. Opin. Pulm. Med., 2000, 6(5), 424–429.

  • 36

    Pego-Reigosa, J. M., Medeiros, D. A., Isenberg, D. A.: Respiratory manifestations of systemic lupus erythematosus: old and new concepts. Best Pract. Res. Clin. Rheumatol., 2009, 23(4), 469–480.

  • 37

    Müller, V.: Interstitial lung disease. In: Somfai, A. (ed.): Pulmonology. [Interstitialis tüdőbetegségek. In: Somfai, A. (szerk.): Pulmonologia.] SpringMed Kiadó, Budapest, 2013. [Hungarian]

  • 38

    Nielepkowicz-Goździńska, A., Fendler, W., Robak, E., et al.: The role of CXC chemokines in pulmonary fibrosis of systemic lupus erythematosus patients. Arch. Immunol. Ther. Exp., 2015, 63(6), 465–473.

  • 39

    Müller, V.: Pulmonary manifestations in connective tissue diseases. [Kötőszöveti betegségek pulmonalis manifesztációi.] MOTESZ Magazin, 2008, 16(1), 25–31. [Hungarian]

  • 40

    Tansey, D., Wells, A. U., Colby, T. V., et al.: Variations in histological patterns of interstitial pneumonia between connective tissue disorders and their relationship to prognosis. Histopathology, 2004, 44(6), 585–596.

  • 41

    Gatto, M., Kiss, E., Naparstek, Y., et al.: In-/off-label use of biologic therapy in systemic lupus erythematosus. BMC Med., 2014, 12, 30.

  • 42

    Carmier, D., Marchand-Adam, S., Diot, P., et al.: Respiratory involvement in systemic lupus erythematosus. Rev. Malad. Respir., 2010, 27(8), e66–e78.

  • 43

    Warrington, K. J., Moder, K. G., Brutinel, W. M.: The shrinking lungs syndrome in systemic lupus erythematosus. Mayo Clinic Proc., 2000, 75(5), 467–472.