3 years ago

Manifestaciones pulmonares en lupus eritematoso sistémico: afección pleural, neumonitis aguda, enfermedad intersticial crónica y hemorragia alveolar difusa

Georgina Aguilera-pickens, Carlos Abud-mendoza

Publication date: September–October 2018

Source: Reumatología Clínica, Volume 14, Issue 5

Author(s): Georgina Aguilera-Pickens, Carlos Abud-Mendoza

Resumen

El lupus eritematoso sistémico (LES) es la enfermedad autoinmune difusa del tejido conectivo que con mayor frecuencia afecta al pulmón, la cual oscila del 20 al 90%, porcentaje variable en función de los criterios empleados en las cohortes estudiadas (sintomatología hasta histopatología). Más del 50% de los pacientes presentan manifestaciones pleuropulmonares por lo menos una vez durante el curso de su enfermedad y tal afección se asocia a mayor mortalidad. Las anomalías pulmonares no correlacionan con marcadores séricos de actividad lúpica. Es prioritario descartar infección pulmonar en la evaluación inicial, ya que la afección parenquimatosa más frecuente es la infección bacteriana y constituye una de las principales causas de muerte. También se han descrito participación de agentes atípicos, que incluyen los que condicionan enfermedades granulomatosas y otros oportunistas. La afección pleuropulmonar en LES puede estar directamente asociada a LES o ser secundaria. Fármacos pueden ocasionar neumonitis e incluso progresión a enfermedad intersticial. Hay un incremento discreto en el riesgo de neoplasias pulmonares.

Abstract

Systemic lupus erythematosus is the diffuse autoimmune connective tissue disease that most frequently involves pulmonary involvement, affecting 20% of 90% of the patients. The percentage varies depending on the defining criteria (symptoms, pulmonary tests or histopathological studies). At least once during the disease course, 50% of those affected have pleural and/or pulmonary manifestations, which are associated with higher morbidity and mortality. Pulmonary involvement has no correlation with lupus activity biomarkers, and it is necessary to rule out infectious processes in the initial approach. Bacterial infection is most frequently the cause of lung involvement in lupus and is one of the most important causes of death. Pulmonary involvement is considered to be primary when it is associated with disease activity, and secondary when other causes participate. Drugs have been reported to be associated with pulmonary damage, including interstitial disease. The incidence of malignant lung diseases is increased in systemic lupus erythematosus. Treatment depends on the type and severity of pulmonary involvement.

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.