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Pneumologische Notfälle bei Kollagenosen und Vaskulitiden

Pulmonary emergencies in connective tissues disorders and vasculitides

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Zusammenfassung

Pneumologische Notfälle in der Rheumatologie sind seltene, im Einzelfall lebensbedrohliche Krankheitsbilder, die bei Patienten mit entzündlichen rheumatischen Systemerkrankungen als Komplikation der Grunderkrankung oder der Therapie auftreten können. Vor allem die diffuse alveoläre Hämorrhagie, Trachealstenosen, akute Pneumonitiden und schließlich der medikamenteninduzierte Lungenschaden gehören in diese Kategorie. Das erfolgreiche Management dieser Fälle erfordert aufseiten der Rheumatologie eine intensive Zusammenarbeit mit der Pneumologie. Diese trägt mit ihren Erfahrungen in der Betreuung verwandter Krankheitsbilder, ihren speziellen endoskopischen Techniken sowie den verschiedenen Formen der Beatmung unverzichtbare Verfahren der Diagnostik und supportiven Therapie bei. Ziel der vorliegenden Übersicht ist die Darstellung des aktuellen Standes der Diagnostik und der modernen Behandlungsmöglichkeiten inklusive der B-Zell-gerichteten Therapien.

Abstract

Pulmonary emergencies in rheumatic diseases are rare, potentially life-threatening conditions that occur either as a manifestation of the disease itself or as an adverse event of immunosuppressive treatment. Diffuse alveolar hemorrhage, tracheal stenosis, acute pneumonitis and drug-induced lung injury belong to this category. The management of these emergencies requires intensive cooperation between rheumatology and pulmonology. The latter contributes its experience in the care of related conditions, specific endoscopic techniques and local interventions as well as the indispensable and life-supporting forms of assisted ventilation. The present article summarizes the current knowledge on diagnostic and therapeutic procedures including the newly available B-cell directed treatments.

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Danksagung

Frau Meike Zahnen danken wir für die sorgfältige Präparation des Manuskriptes. Frau Professor Dr. Beate Stöcklhuber (Radiologische Abteilung des Städtischen Krankenhauses Kiel) sei herzlich gedankt für die Überlassung der CT-Aufnahmen für Abb. 2.

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Medizinische Klinik I, Sektion Rheumatologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 12, 24105, Kiel, Deutschland

    J.O. Schröder & R.A. Zeuner

  2. Medizinische Klinik I, Bereich Pneumologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

    B. Bewig

  3. Klinik für Diagnostische Radiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

    M. Both

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  1. J.O. Schröder
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  2. R.A. Zeuner
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  3. B. Bewig
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  4. M. Both
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Correspondence to J.O. Schröder.

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Schröder, J., Zeuner, R., Bewig, B. et al. Pneumologische Notfälle bei Kollagenosen und Vaskulitiden. Z. Rheumatol. 71, 278–287 (2012). https://doi.org/10.1007/s00393-011-0916-1

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  • DOI: https://doi.org/10.1007/s00393-011-0916-1

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