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Title: | Fibrosing alveolitis in systemic sclerosis: The need for early screening and treatment. | Authors: | Sahhar J. ;Conron M.;Littlejohn G. | Institution: | (Sahhar, Littlejohn) Monash Ctr. for Inflammatory Dis., Monash Medical Centre, Clayton, Vic., Australia (Conron) Department of Respiratory Medicine, St. Vincent's Hospital, Melbourne, Vic., Australia (Sahhar) Monash Ctr. for Inflammatory Dis., Monash Medical Centre, 246 Clayton Road, Clayton, Vic. 3168, Australia | Issue Date: | 19-Oct-2012 | Copyright year: | 2004 | Publisher: | Blackwell Publishing (550 Swanston Street, Carlton South VIC 3053, Australia) | Place of publication: | Australia | Publication information: | Internal Medicine Journal. 34 (11) (pp 626-638), 2004. Date of Publication: November 2004. | Abstract: | Abnormalities in lung function occur in 70% of patients with systemic sclerosis (SSc). Fibrosing alveolitis in SSc (FASSc) is more commonly seen in the diffuse cutaneous form of SSc, particularly in the presence of antitopoisomerase antibodies (Scl70), and with the decreasing incidence of scleroderma renal crisis it is now the major cause of mortality in this patient population. Screening of patients recently diagnosed with SSc by pulmonary function tests and the performance of high resolution computed tomography when physiological abnormalities are identified has resulted in the identification of significant numbers of patients with early, asymptomatic FASSc. Whether these patients should be further investigated with a surgical lung biopsy or receive immunosuppression is unclear, because it cannot yet be reliably predicted who will develop progressive disease and the evidence to support the efficacy of treatment is not strong. The objective of the present article was to review the evidence to support the use of immunosuppressive therapy in FASSc and, based on these data, to propose an algorithm for the investigation and management of this difficult clinical problem. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/j.1445-5994.2004.00674.x | PubMed URL: | 15546457 [http://www.ncbi.nlm.nih.gov/pubmed/?term=15546457] | ISSN: | 1444-0903 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/32494 | Type: | Review | Subjects: | dose response early diagnosis fever/si [Side Effect] *fibrosing alveolitis/di [Diagnosis] *fibrosing alveolitis/dt [Drug Therapy] hematuria/si [Side Effect] hemorrhagic cystitis/si [Side Effect] high resolution computer tomography human pneumonia/si [Side Effect] infection/si [Side Effect] infertility/si [Side Effect] kidney disease/co [Complication] kidney disease/si [Side Effect] leukopenia/si [Side Effect] lung biopsy lung function test lung lavage lung scintiscanning maximum permissible dose myelodysplasia/si [Side Effect] nausea/si [Side Effect] nephrotoxicity/si [Side Effect] osteoporosis/co [Complication] pathology patient monitoring pneumocystosis/dt [Drug Therapy] pneumocystosis/et [Etiology] pneumocystosis/pc [Prevention] thorax radiography vomiting/si [Side Effect] autoantibody/ec [Endogenous Compound] azathioprine/ae [Adverse Drug Reaction] azathioprine/ct [Clinical Trial] azathioprine/cb [Drug Combination] azathioprine/cm [Drug Comparison] azathioprine/dt [Drug Therapy] azathioprine/iv [Intravenous Drug Administration] cotrimoxazole/dt [Drug Therapy] cyclophosphamide/ae [Adverse Drug Reaction] cyclophosphamide/ct [Clinical Trial] cyclophosphamide/ad [Drug Administration] cyclophosphamide/cb [Drug Combination] cyclophosphamide/cm [Drug Comparison] cyclophosphamide/do [Drug Dose] cyclophosphamide/dt [Drug Therapy] cyclophosphamide/iv [Intravenous Drug Administration] cyclophosphamide/po [Oral Drug Administration] interleukin 8/ec [Endogenous Compound] mesna/ae [Adverse Drug Reaction] mesna/cb [Drug Combination] mesna/dt [Drug Therapy] methotrexate/ae [Adverse Drug Reaction] methotrexate/cb [Drug Combination] methotrexate/dt [Drug Therapy] methotrexate/iv [Intravenous Drug Administration] penicillamine/ae [Adverse Drug Reaction] penicillamine/ad [Drug Administration] penicillamine/cb [Drug Combination] penicillamine/dt [Drug Therapy] penicillamine/iv [Intravenous Drug Administration] penicillamine/po [Oral Drug Administration] pentetate technetium tc 99m placebo prednisolone/ae [Adverse Drug Reaction] prednisolone/ct [Clinical Trial] prednisolone/cb [Drug Combination] prednisolone/cm [Drug Comparison] prednisolone/dt [Drug Therapy] prednisolone/po [Oral Drug Administration] tumor necrosis factor alpha/ec [Endogenous Compound] unclassified drug dna topoisomerase antibody/ec [Endogenous Compound] scl 70 antibody/ec [Endogenous Compound] immunosuppressive treatment priority journal review screening *systemic sclerosis/dt [Drug Therapy] algorithm alopecia/si [Side Effect] bladder cancer/si [Side Effect] bladder disease/si [Side Effect] blood toxicity/si [Side Effect] bone marrow suppression/si [Side Effect] cause of death clinical feature clinical trial cytopenia/si [Side Effect] disease marker disease marker dose response early diagnosis fever / side effect *fibrosing alveolitis / *diagnosis / *drug therapy hematuria / side effect hemorrhagic cystitis / side effect high resolution computer tomography human immunosuppressive treatment infection / side effect infertility / side effect kidney disease / complication / side effect leukopenia / side effect lung biopsy lung function test lung lavage lung scintiscanning maximum permissible dose myelodysplasia / side effect nausea / side effect nephrotoxicity / side effect osteoporosis / complication pathology patient monitoring pneumocystosis / drug therapy / etiology / prevention pneumonia / side effect priority journal review screening *systemic sclerosis / *drug therapy thorax radiography vomiting / side effect alopecia / side effect algorithm bladder cancer / side effect bladder disease / side effect blood toxicity / side effect bone marrow suppression / side effect cause of death clinical feature clinical trial cytopenia / side effect |
Type of Clinical Study or Trial: | Review article (e.g. literature review, narrative review) |
Appears in Collections: | Articles |
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