Pulmonary involvement in systemic sclerosis

Morales-Cárdenas, Adriana; Pérez-Madrid, Camila; Arias, Liliana; Ojeda, Paulina; Mahecha, María Paula; Rojas-Villarraga, Adriana; Carrillo-Bayona, Jorge Alberto; Anaya, Juan Manuel

doi:10.1016/j.autrev.2016.07.025

Cited by 60 publications

(30 citation statements)

References 90 publications

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“…Interestingly, CTD‐ILD patients displayed both cellular and fibrotic pCLE patterns, which may reflect the presence of both inflammatory and fibrotic processes in most CTD‐ILD, especially in SSc‐ILD …”

Section: Discussionmentioning

confidence: 99%

In vivo probe‐based confocal laser endomicroscopy in chronic interstitial lung diseases: Specific descriptors and correlation with chest CT

et al. 2019

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Background and objective: Probe-based confocal laser endomicroscopy (pCLE) enables in vivo microimaging of the distal lung, during bronchoscopy. This study aims at identifying pCLE descriptors of chronic interstitial lung diseases (ILD), their correlations with chest HRCT and assessing inter-observer agreement. Methods: pCLE was performed in 21 healthy volunteers (HV) and 59 non-smoking ILD patients, including 19 patients with idiopathic pulmonary fibrosis (IPF) or asbestosis, 15 with connective tissue disease-associated ILD (CTD-ILD), 17 with sarcoidosis and 8 with hypersensitivity pneumonitis (HP). pCLE descriptors were identified in ILD on the basis of comparison with HV. Results: Nine pCLE descriptors were more frequent in ILD compared to HV, with good inter-observer agreement, including fluorescent bronchiolar cells (sarcoidosis, CTD-ILD and HP), fluorescent alveolar cells (CTD-ILD and HP), small alveolar entrance rings (IPF or asbestosis and CTD-ILD), enlarged axial elastic fibres (IPF or asbestosis), septal fibres (IPF or asbestosis, CTD-ILD and HP), disorganized acinar network and rigid acinar network (IPF or asbestosis and CTD-ILD), dense elastic network (IPF or asbestosis) and alveolar fluorescent nodular structures (in sarcoidosis) (P < 0.01, Fisher's exact test, all comparisons). The distribution of nodules on computed tomography (CT) appeared to correlate with pCLE alveolar nodular structures, rigid acinar network and septal fibres, while reticulations were associated with septal fibres and disorganized or dense acinar network; ground-glass opacities on CT with small alveolar entrances, rigid elastic network and septal fibres; and honeycombing with septal fibres. Conclusion:In the four groups of ILD studied, 9 pCLE descriptors are described, which appear specific and reproducible, and correlate with chest HRCT patterns. Clinical trial registration: NCT00377338 at ClinicalTrials.govProbe-based confocal laser endomicroscopy (pCLE) enables to image the acinar and alveolar areas at the microscopic level in vivo during flexible bronchoscopy. This study provides reproducible pCLE descriptors of idiopathic pulmonary fibrosis (IPF), asbestosis, connective-tissue disease-related interstitial lung diseases (ILD), sarcoidosis and hypersensitivity pneumonitis, which can be used to conduct prospective and follow-up studies.

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Section: Discussionmentioning

confidence: 99%

In vivo probe‐based confocal laser endomicroscopy in chronic interstitial lung diseases: Specific descriptors and correlation with chest CT

et al. 2019

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“…lung parenchyma involvement and pulmonary hypertension) and (ii) secondary pulmonary disease (i.e. airway illness due to bronco‐aspiration that is secondary to gastro‐oesophageal reflux, toxicity due to medications, and infections, among others) . The presence of parenchymal lung disease (HR = 2.9, P = 0.023), pulmonary hypertension (HR = 4.78, P = 0.002) and renal disease (HR = 2.78, P = 0.016) is associated with increased mortality in patients with SS in the nontransplant setting.…”

Section: Discussionmentioning

confidence: 99%

Kidney transplantation in patients with systemic sclerosis: a nationwide multicentre study

et al. 2017

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Kidney transplantation is one of the therapeutic options for end-stage renal disease (ESRD) in systemic sclerosis (SS). Current evidence demonstrates poorer patient and graft survival after transplantation in SS than in other primary kidney diseases. All the patients presenting ESRD associated with SS who had received a kidney allograft between 1987 and 2013 were systematically included from 20 French kidney transplantation centres. Thirty-four patients received 36 kidney transplants during the study period. Initial kidney disease was scleroderma renal crisis in 76.4%. Extrarenal involvement of SS was generally stable, except cardiac and gastrointestinal involvements, which worsened after kidney transplantation in 45% and 26% of cases, respectively. Patient survival was 100%, 90.3% and 82.5% at 1, 3 and 5 years post-transplant, respectively. Pulmonary involvement of SS was an independent risk factor of death after transplantation. Death-censored graft survival was 97.2% after 1 and 3 years, and 92.8% after 5 years. Recurrence of scleroderma renal crisis was diagnosed in three cases. In our study, patient and graft survivals after kidney transplantation can be considered as excellent. On this basis, we propose that in the absence of extrarenal contraindication, SS patients presenting with ESRD should be considered for kidney transplantation.

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“…Pulmonary involvement occurs in more than 80% of patients with scleroderma and includes ILD (most common), pulmonary arterial hypertension (PAH), pleural effusion, constrictive bronchiolitis, respiratory muscle weakness, and aspiration pneumonia (related to esophageal dysfunction). 37,39 In recent years, ILD and PAH have become the main causes of scleroderma-related deaths, surpassing renal crisis. 37,38,40 Patients with SSc-ILD typically present with exertional dyspnea or cough but may sometimes be asymptomatic.…”

Section: Radiology Report In Ctds: Essential Elementsmentioning

confidence: 99%

Interstitial Lung Disease and Other Pulmonary Manifestations in Connective Tissue Diseases

Mira-Avendano

Abril

Burger

et al. 2019

Mayo Clinic Proceedings

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Pulmonary involvement in systemic sclerosis

Cited by 60 publications

References 90 publications

In vivo probe‐based confocal laser endomicroscopy in chronic interstitial lung diseases: Specific descriptors and correlation with chest CT

In vivo probe‐based confocal laser endomicroscopy in chronic interstitial lung diseases: Specific descriptors and correlation with chest CT

Kidney transplantation in patients with systemic sclerosis: a nationwide multicentre study

Interstitial Lung Disease and Other Pulmonary Manifestations in Connective Tissue Diseases

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