Hermann J, Kovacs G, Scheidl S
Klinische Abteilung für Rheumatologie, Universitätsklinik für Innere Medizin, Auenbruggerplatz 15, 8036, Graz, Osterreich.
Z Rheumatol. 2008 Sep;67(5):407-10, 412-4. doi: 10.1007/s00393-008-0346-x.
The lungs are involved in many inflammatory rheumatic diseases. We will focus on the most common clinical problems. In systemic sclerosis interstitial lung disease resulting in fibrosis and pulmonary arterial hypertension (PAH) resulting in right heart failure are the leading complications requiring close cooperation between specialists in rheumatology and pulmonology. In Sjogren's syndrome interstitial pneumonia, pleural and bronchial inflammation and rarely PAH will be the main pulmonary complications. Hypereosinophilic syndrome, eosinophilic pneumonia, and Churg-Strauss syndrome are conditions that show marked eosinophilia and can clinically be confused with asthma and allergic bronchopulmonary aspergillosis. These conditions mandate thorough investigation of the lungs including bronchoscopy and possibly open lung biopsy. Finally, patients for whom treatment with tumour necrosis factor blocking agents is planned should undergo interdisciplinary management to prevent tuberculosis activation or infection.
肺部会累及许多炎性风湿性疾病。我们将重点关注最常见的临床问题。在系统性硬化症中,导致纤维化的间质性肺病和导致右心衰竭的肺动脉高压(PAH)是需要风湿病学和肺病学专家密切合作的主要并发症。在干燥综合征中,间质性肺炎、胸膜和支气管炎症以及罕见的PAH将是主要的肺部并发症。高嗜酸性粒细胞综合征、嗜酸性粒细胞肺炎和变应性肉芽肿性血管炎是表现出明显嗜酸性粒细胞增多的病症,临床上可能与哮喘和变应性支气管肺曲霉病相混淆。这些病症需要对肺部进行全面检查,包括支气管镜检查,可能还需要进行开胸肺活检。最后,计划使用肿瘤坏死因子阻断剂进行治疗的患者应接受多学科管理,以预防结核病激活或感染。