- 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 «Ivano–Frankivsk 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.
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