• Bronchopulmonary disorders in children with rheumatic diseases (lecture)

Bronchopulmonary disorders in children with rheumatic diseases (lecture)

PERINATOLOGY AND PEDIATRIC. UKRAINE. 2017.3(71):120-125; doi 10.15574/PP.2017.71.120

Tsymbalista O. L.
State Higher Education Institution «IvanoFrankivsk National Medical University», Ukraine

Pulmonary lesions in rheumatic diseases are observed in almost all patients determining the severity and prognosis. In acute rheumatic diseases, pulmonary vasculitis is typical; in chronic rheumatic diseases, interstitial pneumonitis is often observed. Hemoptysis and pulmonary hemorrhage (pulmonary infarction) typically occur in vasculitis. Pulmonary (alveolar) hemorrhage is rarely observed (up to 5-6% of cases) in children; but with age, its incidence increases to 25% being the probable cause of death from thrombotic vasculopathy as a manifestation of antiphospholipid syndrome. Acute respiratory distress syndrome develops. Pulmonary lesions manifest themselves as bronchial asthma and laryngotracheitis in a third of patients; pneumonia is often observed. Exudative pleurisy is one of the most common manifestations of polyserositis in case of high activity of the process. In pneumonitis with alveolar-capillary block and hypoxia as well as the progression of pulmonary fibrosis, the symptoms of progressive respiratory failure and right ventricular failure are determinative. Bacterial pneumonia with purulent pulmonary complications, pneumothorax and atelectasis often develops. In dermatomyositis, aspiration pneumonia is observed. Chronic interstitial pneumonitis occurs more rarely in children as compared to adults. One of the main clinical manifestations is restrictive respiratory failure. Pulmonary hypertension results from thrombotic vasculopathy (antiphospholipid syndrome), progressive pulmonary fibrosis, vasculitis, and rare — pulmonary arterial thromboembolism.
Key words: bronchopulmonary system, children, rheumatic disease, clinical picture, diagnosis.

References

1. Agapitov LI, Belozerov YuM. (2009). Diagnosis of pulmonary hypertension in children. Russian Bulletin of Perinatology and Pediatrics. 4: 24-31.

2. Sinyachenko OV, Yegudina YeD, Mikuksts VYa et al. (2017). Angiopathy in systemic sclerosis. Ukrainian Journal of Rheumatology. 1: 5-12.

3. Novik GA, Kalinina NM, Abbakumova LN, Kiknadze KT. (2011). Antiphospholipid syndrome in children. Emergency Medicine. 6: 9-12.

4. Belov BS. (2006). Acute rheumatic fever in adolescents. Current Pediatrics. 5; 2: 56-61.

5. Berezhnyi VV, Marushko TV, Marushko YuV. (2013). Clinical pediatric rheumatology: textbook. Kyiv: 266.

6. Paleyev NP. (2000). Respiratory diseases. Moscow, Meditsina: (728).

7. Boiarchuk OR. (2016). Current views for the diagnosis of acute rheumatic fever according to revision of the Jones criteria 2015. Sovremennaya pediatriya. 8: 90-93.

8. Boiarchuk OR. (2012). Features of subclinical chronic rheumatic heart disease. Ukrainian Journal of Rheumatology. 2: 28-32.

9. Baranova AA, Bazhenova LB. (2002). Pediatric rheumatology: a guide for physicians. Moscow, Meditsina: 338.

10. Sirenko YuM, Radchenko HD, Zhyvylo IO. (2016). Experience of right heart and pulmonary artery catheterization in patients with pulmonary hypertension. Heart and Vessels. 4: 23-29.

11. Agapinov LI, Belozerov YuM, Mizernitskiy YuL, Tsyplenkova SE. (2013). The importance of diastolic dysfunction and the reduction in the right ventricular diastolic reserve in the diagnosis of pulmonary heart disease in children. Russian Bulletin of Perinatology and Pediatrics. 6: 52-57.

12. Koneva OA, Ovsyannikova OB, Starovoytova MN et al. 2016. Isolated decrease of the lung diffusing capacity in patients with systemic sclerosis without pulmonary arterial hypertension: a long-term prospective study. Pulmonology. 26(6): 708-714. https://doi.org/10.18093/0869-0189-2016-26-6-708-714

13. Kogan YeA, Kornev BM, Popova YeN et al. (2007). Interstitial lung disease: a practical guide. Muknin NA, editor. Moscow, Litterra: 432.

14. Kamenetskyi MS, Pervak MB. (2006). X-ray diagnosis of pulmonary changes in systemic lupus erythematosus, nodular periarteritis and systemic sclerosis. Radiation Diagnostics, Radiation Therapy. 1: 8-12.

15. Petrova DV, Shoykhet YaN, Berestov SA, Dorokhov LYe. (2012). Clinical manifestations of systemic lupus erythematosus accompanied by respiratory disorders. Pulmonology. 3: 88-92.

16. Koval HYu, Syvachenko TP, Zahorodska MM et al. (1998). X-ray diagnostics. Koval HYu, editor. Kyiv. Orbis. 1: 177-179.

17. Protsenko HO, Strenko YuM. (2016). Pulmonary hypertension in patients with systemic sclerosis. 4: 75-78.

18. Chuchalin AG. (2009). Pulmonology: a national guideline. Chuchalin AG, editor. Moscow, GEOTAR-Media: 960.

19. Nasonova YeL, Nasonova VA. (2008). Rheumatology: a national guideline. Nasonova YeL, Nasonova VA, editors. Moscow, GEOTAR-Media: 720.

20. Guidelines of the European Society of Cardiology and the European Respiratory Society for the Diagnosis and Treatment of Pulmonary Hypertension 2015. (2016). Arterial Hypertension. 3: 100-134.

21. Reshetnyak TM, Seredavkina NV, Nasonov YeL. (2008). Cardiovascular aspects of antiphospholipid syndrome. Clinical Medicine. 9: 4-11.

22. Rosenshtraukh LS, Rybakova NI, Vinner MG. (1987). X-ray diagnosis of respiratory diseases: a guide for physicians. Moscow, Meditsina: 640.

23. Geppe NA, Podcherniayeva NS, Lyskina GA. (2011). Manual of pediatric rheumatology. Geppe NA, Podcherniayeva NS, Lyskina GA, editors. Moscow, GEOTAR-Media: 720.

24. Rozinova NN, Mizernitskiy YuL. (2011). Chronic pulmonary diseases. Rozinova NN, Mizernitskiy YuL, editors. Moscow, Praktika: 224.

25. Churylin RYu. (2004). Structure and features of pulmonary damage in children and adolescents with systemic lupus erythematosus according to the results of radiological methods of investigation. 12: 243-248.

26. Carapetis IR, Beaton A, Cunningham MW et al. (2016). Acute rheumatic fever and rheumatic heart disease. Nature Reviews. Disease Primes. 2: 1-24.

27. Atatoa-Carr P, Lennon D, Nigel Wilson. (2008). Rheumatic fever diagnosis, management and secondary prevention: a New Zealand guideline. The New Zealand Medical Journal. 121; 1271: 59-69.

28. Beaton A, Carapetis JR. (2015). The 2015 revision of the Jones criteria for the diagnosis of acute rheumatic fever: implications for practice in low-income and middle-income countries. Heart Asia. 7: 7-11.

29. Galie N, Hоeper MM, Humbert M et al. (2011). Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 34: 1219-1263.

30. Moore OA, Goh N, Corte T et al. (2013). Extent of disease on high-resоlution computed tomography lung is a predictor of decline and mortality in systemic sclerosis-related interstitial lung disease. Am J Respir Rheumatology. 52(1): 1248-1254.

31. Elhai M, Meune C, Kahan A, Allanore Y. (2012). Trends in mortality in patients with systemic sclerosis over 40 years: a systemic review and meta-analysis of cohort studies. Rheumatology. 57:1017-1026.

32. Trad S, Huongdu LT, Frances C et al. (2011). Impaired carbon monoxide diffusing capacity as a marker of limited systemic sclerosis. Eur J Intern Med. 22(6): 80-86.

33. Hoeper MM. (2002). Pulmonary hypertension in collagen vascular disease. Eur Resp J. 9: 571-576.

34. Nayhtyanova SI, Schreiber BE, Ong VH et al. (2014). Prediction of pulmonary complication and long-term survival in systemic sclerosis. Arthrit Rheum. 66(6): 1625-1635.

35. Tashkin DP, Volkmann ER, Tseng CH et al. (2016). Relationship between quantitative radiographic assessments of interstitial lung disease and physiological and clinical features of systemic sclerosis. Rheum Dis. 75(2): 374-381.

36. Pavec JLe, Launay D, Mathai SC et al. (2011). Scleroderma lung disease. Clin Rev Allergy Immunol. 40: 104-116.