3 years ago

Pneumopathies non infectieuses induites par les biothérapies ciblées

Philippe Bonniaud, Guillaume Beltramo, Clément Foignot, Paul Ornetti, Marjolaine Georges

Publication date: June 2018

Source: Revue du Rhumatisme Monographies, Volume 85, Issue 3

Author(s): Philippe Bonniaud, Guillaume Beltramo, Clément Foignot, Paul Ornetti, Marjolaine Georges

Résumé

Les biothérapies des rhumatismes inflammatoires chroniques ont révolutionné leur prise en charge. Ces nouveaux médicaments sont susceptibles d’induire des effets secondaires multiples, parfois sévères et ceux-ci peuvent atteindre l’appareil respiratoire. Les présentations cliniques et radiologiques sont multiples et l’apparition de symptômes respiratoires chez un patient sous biothérapie doit faire suspecter un effet iatrogénique avec au premier plan la survenue de pneumopathies interstitielles diffuses parfois très sévères, de granumolatoses et d’anomalies auto-immunes. La complication infectieuse doit toujours être éliminée. La démarche est complexe et doit être rigoureuse ce d’autant que la maladie rhumatismale est, par elle-même, associée à des atteintes pneumologiques variées.

Abstract

The use of biologics has shown strong clinical benefits in patients with rheumatic diseases. Biologics-induced lung disease may manifest as variable clinical radiological patterns, including interstitial lung diseases, sarcoid-like or auto-immune manifestations. Although some risk factors have been identified, the precise mechanisms of biologics-induced infiltrative lung disease are largely unknown. Drug causality should be carefully evaluated and infectious diseases ruled out.

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