Beneficial effect of intravenous cyclophosphamide and oral prednisone on D‐penicillamine‐associated bronchiolitis obliterans

Laar, Mart Afj van de; Westermann, C. J. J.; Wagenaar, Sjoerd Sc.; Dinant, Huibert J.

doi:10.1002/art.1780280115

Cited by 38 publications

(20 citation statements)

References 17 publications

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“…Lung function further deteriorated in half of the patients, despite therapy, with chronic respiratory failure in 40%, and death in 16%. The use of high-dose corticosteroids, cyclophosphamide, and of erythromycin, has been suggested [6,19,20], but has been poorly evaluated. It is not known whether early diagnosis and treatment with inhaled or high-dose oral corticosteroids, or cyclophosphamide, will decrease progression of OB.…”

Section: Discussionmentioning

confidence: 99%

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Devouassoux

Cottin²,

Lioté³

et al. 2009

Eur Respir J

108

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The characteristics of patients with rheumatoid arthritis (RA) who develop obliterative bronchiolitis characterised by severe airflow obstruction have been hitherto poorly investigated.A retrospective study of 25 patients with RA and functional evidence of obliterative bronchiolitis (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ,50% and/or residual volume (RV)/total lung capacity (TLC) .140% predicted) was conducted.Patients (mean¡SD age 64¡11 yrs) included 17 never-smokers and eight ex-smokers (10.5¡5.4 pack-yrs). The diagnosis of RA preceded respiratory symptoms in 88% of cases. Dyspnoea on exertion was present in all patients and bronchorrhea in 44%. High-resolution computed tomography findings included: bronchial wall thickening (96%), bronchiectasis (40%), mosaic pattern (40%), centrilobular emphysema (56%), and reticular and/or ground-glass opacities (32%). Pulmonary function tests showed: FEV1 41¡12% pred, FEV1/FVC 49¡14%, FVC 70¡20% pred, RV 148¡68% pred and RV/TLC 142¡34% pred. Lung biopsy, available in nine patients, demonstrated constrictive, follicular and mixed bronchiolitis. Patients were followed for 48.2¡49 months. Treatment was poorly effective. Chronic respiratory failure occurred in 40% of patients, and four patients died.Obliterative bronchiolitis associated with rheumatoid arthritis is a severe and under-recognised condition leading to respiratory failure and death in a high proportion of patients.

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Section: Discussionmentioning

confidence: 99%

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Devouassoux

Cottin²,

Lioté³

et al. 2009

Eur Respir J

108

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“…The prognosis of OB associated with D-penicillamine is poor, with an estimated mortality of 50%. There is little evidence that systemic steroids are effective, although a trial of therapy is recommended [214,215].…”

Section: D-penicillaminementioning

confidence: 99%

The lung in rheumatoid arthritis

2011

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“…This is an infrequent occurrence, and the joint manifestations appear within months to several years. However, all previous reports of bronchiolitis obliterans complicating rheumatoid arthritis occurred in ongoing, well-established disease [3,4,7,[11][12][13][14][15][16][17][18][19][20]. Of these 31 cases, which included 13 patients who were receiving penicillamine and three patients receiving gold treatment, all but two were in women.…”

Section: Discussionmentioning

confidence: 99%

Bronchiolitis obliterans: the lone manifestation of rheumatoid arthritis?

Schwarz¹,

Lynch²,

Tuder³

1994

Eur Respir J

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B Br ro on nc ch hi io ol li it ti is s o ob bl li it te er ra an ns s: : t th he e l lo on ne e m ma an ni if fe es st ta at ti io on n o of f r rh he eu um ma at to oi id d a ar rt th hr ri it ti is s? ? This case is unusual since it appeared in a man and is the first and, so far, the only manifestation of rheumatoid arthritis. Prior studies indicate that the bronchiolitis obliterans of rheumatoid arthritis occurs primarily in women and only in ongoing cases.

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Beneficial effect of intravenous cyclophosphamide and oral prednisone on D‐penicillamine‐associated bronchiolitis obliterans

Cited by 38 publications

References 17 publications

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

The lung in rheumatoid arthritis

Bronchiolitis obliterans: the lone manifestation of rheumatoid arthritis?

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