ISSN:
1432-1750
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Zusammenfassung Die klinischen und atemphysiologischen Befunde bei 9 Patienten mit primär-chronischer Polyarthritis (PCP) und 5 Patienten mit Lupus erythematodes disseminatus (LED) werden beschrieben. Obwohl nur in 5 Fällen mit PCP ein röntgenologischer Anhalt für eine diffuse Lungenbeteiligung vorlag, zeigte sich bei allen Patienten mit PCP bzw. LED eine deutliche Störung der Diffusion (CO-Ein-Atemzug-Methode), die häufig mit einer Restriktion und — wo untersucht — mit einer alveolären Hyperventilation einherging. Nach Diskussion der funktionellen und morphologischen Ursachen der Diffusionsstörungen wird die Bedeutung der atemphysiologischen Untersuchungen für diese beiden verwandten Krankheitsbilder aufgezeigt.
Notes:
Abstract The clinical data (Table 1) and pulmonary physiologic findings (Table 2) in nine patients with rheumatoid arthritis (RA) and in five patients with systemic lupus erythematosus (SLE) are described. Only 5 patients with RA showed roentgenologic evidence of a diffuse involvement of the lungs. Thex-rays of the remaining 4 patients with RA as well as of 4 patients with SLE looked normal. Yet in all cases a marked lowering of the diffusing capacity (CO-single-breath-method) was found. This defect in diffusion tended to be associated with restriction and (when investigated) with alveolar hyperventilation. Fig. 2 shows the results of VC, DLCO and DL/VL in the patients with RA and roentgenologic diffuse pulmonary fibrosis (group I) and in the patients with RA and normal roentgenologic appearance (group II). Although the mean values of group I are lower, statistically no significant difference was found. For comparison the results in patients with SLE are added (group III). The findings demonstrate that a lowered diffusing capacity may indicate a pulmonary involvement in patients with RA or SLE when other physiologic, clinical or roentgenologic criteria are normal. This is documented by one case, in which the pulmonary manifestation, suspected by a defect in diffusion, was proved histologically although thex-ray looked normal (Fig. 1a and b). In addition, the measurement of the diffusing capacity appears to be an ideal method to observe the progression of the pulmonary involvement and to evaluate the response to treatment. In patients with RA the abnormal diffusion may be the indication for therapy with corticosteroids. The high incidence of normal roentgenologic findings associated with a diffusion defect in our study may explain the difficulty other authors had to demonstrate a statistically significant correlation between RA and pulmonary manifestation when only roentgenologic symptoms were taken as criteria. The functional and morphologic reasons for the lowering of the diffusing capacity are discussed, as is the value of pulmonary physiologic measurements in the study of these two related disease states.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF02136751
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