RESUMO
Collagen diseases are a large group of systemic inflammatory diseases of autoimmune etiology. The etiopathogenesis of collagen diseases is multifactorial. There is genetic susceptibility, as many connective tissue disorders show family history, and environmental factors may trigger the disease. Collagen diseases can affect almost all the organs of the body. The respiratory system is one of the most frequently affected, although the prevalence of pulmonary disease is not precisely known for the different collagen disorders. Any structure of the respiratory tract can be affected, but perhaps the most frequent is pulmonary parenchymal disease in the form of pneumonitis, which can be produced in any of the idiopathic interstitial pneumonitis patterns. The pleura, pulmonary vessels, airways and respiratory muscles may also be affected. The frequency of lung disease associated with collagen diseases is on the rise. This due in part to the better diagnostic methods that are available to us today (such as high-resolution computed tomography) and also to the appearance of new forms of pneumonitis associated with the new treatments that are currently used. The objective of this article is to offer a global vision of how collagen diseases can affect the lungs according to the latest scientific evidence.
Assuntos
Doenças do Colágeno/complicações , Pneumopatias/etiologia , Bronquiectasia/etiologia , Bronquiolite Obliterante/etiologia , Síndrome de Caplan/etiologia , Doenças do Colágeno/fisiopatologia , Humanos , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/fisiopatologia , Pneumopatias/fisiopatologia , Doenças Pulmonares Intersticiais/etiologia , Doenças Pulmonares Intersticiais/fisiopatologia , Transtornos Linfoproliferativos/etiologia , Derrame Pleural/etiologia , Pneumonia/etiologia , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/fisiopatologiaAssuntos
Síndrome de Caplan/etiologia , Minas de Carvão , Doenças Profissionais/epidemiologia , Idoso , Artrite Reumatoide/complicações , Artrite Reumatoide/epidemiologia , Síndrome de Caplan/diagnóstico por imagem , Síndrome de Caplan/epidemiologia , Tchecoslováquia , Exposição Ambiental , Alemanha Ocidental , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Fator Reumatoide/análise , Dióxido de Silício , Silicose/complicações , Silicotuberculose/epidemiologia , País de GalesAssuntos
Artrite Reumatoide , Pulmão/patologia , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/história , Artrite Reumatoide/patologia , Síndrome de Caplan/tratamento farmacológico , Síndrome de Caplan/etiologia , Síndrome de Caplan/patologia , Granuloma/tratamento farmacológico , Granuloma/etiologia , Granuloma/patologia , História do Século XIX , História do Século XX , Humanos , Pneumopatias/patologia , Derrame Pleural/tratamento farmacológico , Derrame Pleural/etiologia , Derrame Pleural/patologia , Pleurisia/patologiaAssuntos
Pneumoconiose/epidemiologia , Asbestose/diagnóstico , Asbestose/epidemiologia , Asbestose/etiologia , Síndrome de Caplan/diagnóstico , Síndrome de Caplan/etiologia , Diagnóstico Diferencial , Humanos , Pneumoconiose/diagnóstico , Pneumoconiose/etiologia , Fibrose Pulmonar/diagnóstico , Fibrose Pulmonar/etiologia , Silicose/diagnóstico , Silicose/epidemiologia , Silicose/etiologia , SuéciaRESUMO
A case of a 56-years old male with rheumatoid arthritis and unclear tumoral radiological changes in the lungs was described. Since noninvasive diagnostic procedures failed to explain nature of the pulmonary changes, an open pulmonary biopsy was performed. Pathological examination revealed presence of rheumatoid nodules and pneumoconiosis, typical for Caplan's syndrome. In the past, the patient had been working in foundry industry for 16 years and he had been exposed to silica and iron dust. Articular symptoms were revealed prior to finding the lung changes even dust exposure had occurred many years earlier. In spite of the fact that rheumatoid arthritis is a relatively common disease and pneumoconiosis is also not rare entity, the coexistence of both conditions i.e. Caplan's syndrome has been rarely diagnosed and described.
Assuntos
Síndrome de Caplan/diagnóstico , Artrite Reumatoide/diagnóstico , Síndrome de Caplan/etiologia , Diagnóstico Diferencial , Poeira , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Nódulo Reumatoide/diagnóstico por imagem , Siderose/complicações , Silicose/complicaçõesRESUMO
Rheumatoid changes in the lungs are seen in 30% of cases of rheumatoid arthritis. Three cases with different patterns of pulmonary involvement in the course of rheumatoid arthritis (RA) are presented. In all cases pleural involvement was seen, in two subjects since the beginning, in the remaining in the course of developing interstitial lung disease. In two cases the dominant changes in the respiratory system were interstitial pneumonitis. In one case the interstitial pneumonitis took a fulminating course, being resistant to treatment with prednisone, endoxan, penicillamine. In the third case, the interstitial pneumonitis was of chronic character, despite the fact that the subject did not receive any treatment, it did not progress. In the first case the main features were pulmonary cavities. The could have evolved from necrosis of rheumatoid nodules or vessel changes.
Assuntos
Artrite Reumatoide/complicações , Síndrome de Caplan/etiologia , Derrame Pleural/etiologia , Pneumoconiose/etiologia , Fibrose Pulmonar/etiologia , Adulto , Síndrome de Caplan/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural/diagnóstico , Fibrose Pulmonar/diagnósticoRESUMO
A 46-year-old woman suffering from rheumatoid arthritis developed numerous round opacities at the apex of the right lung 11 years after an exposure to dolomite . Resected lung showed discrete nodules, 0.8-2 cm in diameter, with central necrosis surrounded by palisading fibroblasts and a prominent inflammatory zone. A large number of birefringent dust particles were seen in the necrotic centres and around the nodules. By electron microscopy the particles were dense, mostly elongated and lamellar, varying from 0.005 to 3 microns in width, and from 0.1 to 6.5 microns in length. Energy dispersive x-ray microanalysis of the dust particles gave elemental spectra with high spikes of silicon, aluminium and potassium, and minimal magnesium, calcium, iron and titanium. According to chemical analysis, the original dolomite consisted almost entirely of magnesium and calcium carbonates and only of traces of silicon, aluminium and potassium. Apparently the human organism can better eliminate calcium and magnesium carbonates than silicon, aluminium and potassium.
Assuntos
Carbonato de Cálcio/efeitos adversos , Síndrome de Caplan/etiologia , Magnésio/efeitos adversos , Minerais/efeitos adversos , Pneumoconiose/etiologia , Carbonato de Cálcio/análise , Síndrome de Caplan/metabolismo , Síndrome de Caplan/patologia , Microanálise por Sonda Eletrônica , Feminino , Humanos , Magnésio/análise , Microscopia Eletrônica , Pessoa de Meia-Idade , Minerais/análise , MineraçãoRESUMO
Pulmonary complications caused by rheumatoid arthritis are a clinically relevant aspect of this chronic arthropathy. Those complications can involve all parts of the thorax, including the lung parenchyma, the pleura, and the thoracic cage. The most common complications are necrobiotic nodules, pleural abnormalities, Caplan's syndrome, parenchymal fibrosis, bronchiolitis obliterans, and iatrogenic damage of lung the parenchyma. This article reviews pulmonary abnormalities induced by rheumatoid arthritis and their clinical and radiological findings. In addition, the role of different imaging modalities in the diagnostic work-up of pulmonary complications caused by rheumatoid arthritis is discussed.
Assuntos
Artrite Reumatoide/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Síndrome de Caplan/diagnóstico por imagem , Síndrome de Caplan/etiologia , Humanos , Pneumopatias/etiologia , Fibrose Pulmonar/diagnóstico por imagem , Fibrose Pulmonar/etiologiaRESUMO
Frequency and type of pulmonary and pleural involvement in collagen disease (rheumatoid arthritis, progressive systemic scleroderma, polymyositis-dermatomyositis and lupus erythematodes are analysed on the basis of literature and of own cases with particular regard to the roentgenographic appearance.