Sunday 23 September 2012

Pulmonary involvement in systemic diseases

Rheumatoid arthritis
  • Rheumatoid factor is always present
  • Lung features may precede arthropthy

Systemic lupid erythematosus
  • Pleurisy/ pleural effusion

Systemic sclerosis
  • Pulmonary fibrosis/ honeycomb lung

Wegener's granulomatosis
  • Granulomatous vasculitis of small arteries
  • Rhinorrhoea
  • Nasal ulceration
  • Nodular masses (+/- cavitation)
  • Migratory pulmonary infiltrates
  • Associated with antineutrophil cytoplasmic antibodies (c-ANCA)
  • Treated with cyclophosphamide

Churg-Strauss syndrome
  • Systemic vasculitis
  • Asthma
  • Rhinitis
  • Eosinophilia
  • Associated with ANCA (p-ANCA)
  • Treated with steroids

Goodpasture's syndrome
  • Disease associated with anti-glomerular basement membrane (GBM) antibodies which cross-react with the glomerulus and the lung
  • Cough
  • Haemoptysis (Can be massive)
  • Intrapulmonary haemorrhage
  • Glomerulonephritis
  • Treated with steroids

Pulmonary fibrosis and honeycomb lung
  • Localised
    • Systemic sclerosis
    • Sarcoidosis
    • Tuberculosis
    • Asbestosis
    • Berylliosis
  • Diffuse
    • Cryptogenic fibrosing alveolitis
    • Rheumatoid lung
    • Langerhans' cell histiocytosis
    • Tuberous sclerosis
    • Neurofibromatosis

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