1
|
López-Reyes R, García-Ortega A, Gómez Olivas JD, Prado Barragan M, Calvillo Batlles P, Iborra Cortés J. Hipertensión arterial pulmonar grave en paciente con polimiositis-dermatomiositis. OPEN RESPIRATORY ARCHIVES 2020. [DOI: 10.1016/j.opresp.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
2
|
Halpenny D, Suh J, Garofano S, Alpert J. A 29-Year-Old Man With Nonproductive Cough, Exertional Dyspnea, and Chest Discomfort. Chest 2015; 148:e80-e85. [DOI: 10.1378/chest.14-2936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
|
3
|
Pouessel G, Thumerelle C, Nève V, Santangelo T, Flammarion S, Pruvot I, Tillie-Leblond I, Deschildre A. [Lung is also involved in juvenile dermatomyositis]. Rev Med Interne 2014; 35:461-5. [PMID: 24856457 DOI: 10.1016/j.revmed.2014.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/24/2014] [Accepted: 04/14/2014] [Indexed: 12/18/2022]
Abstract
Juvenile dermatomyositis is the leading cause of chronic idiopathic inflammatory myopathy of auto-immune origin in children. Lung involvement in inflammatory myopathies is well described in adults, involving mostly interstitial lung disease, aspiration pneumonia and alveolar hypoventilation. We propose to describe its specificities in children. Pulmonary involvement may be asymptomatic and therefore must be systematically screened for. In case of clinical or functional respiratory abnormality, a chest computed tomographic (CT) scan is necessary. In children, a decrease of respiratory muscle strength seems common and should be systematically and specifically searched for by non-invasive and reproducible tests (sniff test). Interstitial lung disease usually associates restrictive functional defect, impairment of carbon monoxide diffusion and interstitial lung disease on CT scan. As in adults, the first-line treatment of juvenile dermatomyositis is based on corticosteroids. Corticosteroid resistant forms require corticosteroid bolus or adjuvant immunosuppressive drugs (methotrexate or cyclosporine). There is no consensus in pediatrics for the treatment of diffuse interstitial lung disease. Complications of treatment, including prolonged steroid therapy, are frequent and therefore a careful assessment of the treatments risk-benefit ratio is necessary, especially in growing children.
Collapse
Affiliation(s)
- G Pouessel
- Unité de pneumologie et allergologie pédiatriques, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France; Service de pédiatrie, hôpital Victor-Provo, 59100 Roubaix, France
| | - C Thumerelle
- Unité de pneumologie et allergologie pédiatriques, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France
| | - V Nève
- Unité d'exploration fonctionnelle respiratoire pédiatrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France
| | - T Santangelo
- Service d'imagerie thoracique, hôpital Calmette, CHRU, 59037 Lille cedex, France
| | - S Flammarion
- Unité de pneumologie et allergologie pédiatriques, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France; Service de pédiatrie, hôpital Victor-Provo, 59100 Roubaix, France
| | - I Pruvot
- Unité de rhumatologie pédiatrique, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille cedex, France
| | - I Tillie-Leblond
- Service de pneumologie et d'immuno-allergologie, hôpital Calmette, CHRU, 59037 Lille cedex, France
| | - A Deschildre
- Unité de pneumologie et allergologie pédiatriques, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France.
| |
Collapse
|
4
|
Ahmed S, Palevsky HI. Pulmonary Arterial Hypertension Related to Connective Tissue Disease. Rheum Dis Clin North Am 2014; 40:103-24. [DOI: 10.1016/j.rdc.2013.10.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
5
|
Bizien N, Renault A, Boles JM, Delluc A. [Acute interstitial lung disease revealing antisynthetase syndrome]. REVUE DE PNEUMOLOGIE CLINIQUE 2011; 67:367-370. [PMID: 22137282 DOI: 10.1016/j.pneumo.2011.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 01/13/2011] [Accepted: 01/19/2011] [Indexed: 05/31/2023]
Abstract
INTRODUCTION The antisynthetase syndrome is characterized by the presence of myositis, interstitial lung disease, arthritis, Raynaud's phenomenon, mechanics hands and anti-Jo1 antibody (histidyl tRNA synthetase). The prognosis of this syndrome is closely related to the severity of lung disease. Myositis can occur several years after lung disease and some patients with interstitial lung disease associated with anti-Jo1 antibodies will not suffer from muscle disease. CASE-REPORT We report the case of a 69-year-old man admitted to the medical intensive care unit for acute respiratory insufficiency related to rapidly progressive interstitial lung disease. Antisynthetase syndrome was diagnosed the presence of wrists' arthritis, 'mechanic's hands and anti-Jo1 antibodies. Despite the dramatic efficacy of corticosteroid therapy on ventilation parameters, the patient died from a Pseudomonas Aeruginosa nosocomial ventilator-acquired pneumonia. CONCLUSION Our case emphasizes the importance to search for anti-Jo1 antibodies in the presence of interstitial lung disease. During the course of antisynthetase syndrome, the occurrence of interstitial lung disease is almost always constant and is correlated with poor prognosis.
Collapse
Affiliation(s)
- N Bizien
- Département de médecine interne et pneumologie, CHU de Brest, France.
| | | | | | | |
Collapse
|
6
|
Feuillet S, Tazi A. [Acute interstitial pneumonia: diagnostic approach and management]. Rev Mal Respir 2011; 28:809-22. [PMID: 21742242 DOI: 10.1016/j.rmr.2011.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 01/27/2011] [Indexed: 01/15/2023]
Abstract
Acute interstitial pneumonia (AIP) encompasses a spectrum of pulmonary disorders characterized by involvement of the lung interstitium and distal airways (bronchioles and alveoli). The onset of respiratory symptoms is acute, most often within two weeks. Most AIP take place de novo, but sometimes represent an acute exacerbation of chronic lung disease. The clinical presentation of AIP comprises rapidly progressive dyspnoea, associated sometimes with cough, fever, myalgia and asthenia. Chest radiography shows diffuse pulmonary opacities. The associated hypoxemia may be severe enough to cause acute respiratory failure. Underlying aetiologies are numerous and variable, particularly in relation to the underlying immune status of the host. Various histopathological entities may be responsible for AIP although diffuse alveolar damage is the predominant pattern. The diagnostic approach to a patient presenting with AIP is to try to determine the most likely underlying histopathological pattern and to search for a precise aetiology. It relies mainly on a meticulous clinical evaluation and accurate biological investigation, essentially guided by the results of bronchoalveolar lavage performed in an area identified by abnormalities on high resolution computed tomography of the lungs. Initial therapeutic management includes symptomatic measures, broad-spectrum antibiotic treatment adapted to the clinical context, frequently combined with systemic corticosteroid therapy.
Collapse
Affiliation(s)
- S Feuillet
- Service de pneumologie, hôpital Saint-Louis, université Denis-Diderot, AP-HP, Paris cedex 10, France
| | | |
Collapse
|
7
|
Brillet P, Mama N, Nunes H, Uzunhan Y, Abbad S, Brauner M. Sémiologie tomodensitométrique de l’atteinte pulmonaire des connectivites. ACTA ACUST UNITED AC 2009; 90:1854-68. [DOI: 10.1016/s0221-0363(09)73288-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
8
|
Meurice J, Roche N. « La Revue des Maladies Respiratoires : l’aventure continue ». Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)91006-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|