Abstract:Lung tissue obtained from eight consecutive patients with systemic lupus erythematosus complicated by severe, acute pulmonary disease was studied by both light and immunofluorescence microscopy. Light microscopic examination disclosed interstitial pneumonia in four cases, cytomegalovirus pneumonitis in one case, bronchiolitis and peribronchiolitis in one case, pulmonary infarction in one case and focal atelectasis in the remaining case. Direct immunofluorescence examination revealed focally bound immunoglobuli… Show more
“…The effectiveness of plasmapheresis in patients with acute lupus pneumonia or with alveolar haemorrhage (AH) suggests the importance of autoantibodies in the pathophysiology of this pulmonary damage [15,16]; • the CIC deposits in human SLE prove their implication in the disease. Immunoglobulins with or without complement have been found in the alveolar walls and capillaries of patients with diffuse infiltrating pneumonia [14,17]. This hypothesis is reinforced by the presence of DNA, IgG and C3 on immunofluorescent microscopy of lung tissue in patients with acute lupus [18].…”
“…The effectiveness of plasmapheresis in patients with acute lupus pneumonia or with alveolar haemorrhage (AH) suggests the importance of autoantibodies in the pathophysiology of this pulmonary damage [15,16]; • the CIC deposits in human SLE prove their implication in the disease. Immunoglobulins with or without complement have been found in the alveolar walls and capillaries of patients with diffuse infiltrating pneumonia [14,17]. This hypothesis is reinforced by the presence of DNA, IgG and C3 on immunofluorescent microscopy of lung tissue in patients with acute lupus [18].…”
“…In pleural biopsy specimens from 3 patients with drug-induced lupus pleural effusions [90] and autopsy pleural specimens from patients with SLE [91], a specific immunofluorescent pattern has been observed, characterized by diffuse and speckled staining of cell nuclei with anti-IgG, anti-IgM or anti-C3 [90]. Thoracoscopy reveals nodules on the visceral pleura, and immunofluorescence of biopsy samples of these nodules demonstrated immunoglobulin deposits [63, 92].…”
Systemic autoimmune diseases, a heterogeneous group of immunologically mediated inflammatory disorders including multiorgan involvement, can affect the pleura with various frequencies, either as a single presenting feature or as part of multisystem involvement. Rheumatoid arthritis and systemic lupus erythematosus represent the most common immunological diseases that affect the pleural cavity; however, there is considerable variation regarding the reported prevalence, natural history and prognosis of pleural involvement in both conditions. The definition of pleural disease in the remaining systemic autoimmune disorders is unquestionably imprecise and assumptive, since it is risky to support premises based on single case reports or retrospective data from very small series. In this article, we will review the manifestations of pleural disease caused by rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyositis/dermatomyositis, mixed connective tissue disease, ankylosing spondylitis, Sjögren’s syndrome and Wegener’s granulomatosis.
Lung-reactive antibodies were detected in sera of patients with farmer’s lung disease and in sera of healthy persons. A solid-phase radioimmunoassay was adapted for measurement of titers of human antibodies to sodium-dodecyl-sulfate-solubilized lung proteins. The titers of antilung antibodies in patients sera were 2–5 times as much as those of healthy persons. Using the immunoblotting technique, antibodies to individual lung polypeptides could be detected. Although the specificity patterns of antibodies to lung polypeptides differed from one serum to another, patients sera contained, in general, antibodies to larger numbers of lung polypeptides as compared to sera of healthy persons. The relationship between antilung antibodies and hypersensitivity pneumonitis is discussed.
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