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Der Internist

, Volume 59, Issue 9, pp 898–910 | Cite as

Vaskulitiden und eosinophile Lungenerkrankungen

  • C. KroegelEmail author
  • M. Foerster
  • S. Quickert
  • H. Slevogt
  • T. Neumann
Schwerpunkt: Lunge bei Systemerkrankungen

Zusammenfassung

Eosinophile Granulozyten bilden von Th2-Lymphozyten dirigierte periphere Effektorzellen, die über die Freisetzung von zytotoxischen basischen Proteinen und Sauerstoffradikalen eine lokale Zell‑, Gewebe- und Funktionsstörung infiltrierter Organe verursachen. Zu den Eosinophilen-assoziierten Erkrankungen der Lunge gehört die eosinophile Granulomatose mit Polyangiitis (EGPA), die akute und chronische eosinophile Pneumonie und die Organmanifestation beim hypereosinophilen Syndrom oder bei bestimmten Parasitosen. In der Lunge manifestieren sich vor allem die Vaskulitiden der kleinen Gefäße (EGPA, Granulomatose mit Polyangiitis, mikroskopische Polyangiitis). Zu den mit Eosinophilie einhergehen pulmonalen Vaskulitiden gehört vor allem EGPA. Zudem gibt es verschiedene Overlap-Syndrome, bei denen EGPA-Charakteristika bei anderen ANCA-assoziierten (ANCA: antineutrophile-zytoplasmatische-Antikörper) Vaskulitiden nachzuweisen sind. Gelegentlich treten nicht-ANCA-assoziierte pulmonale Vaskulitiden mit Eosinophilen auf (z. B. Purpura Schönlein-Henoch, Kawasaki-Erkrankung, medikamenteninduzierte Hypersensitivität, paraneoplastische Syndrome). Die mit Eosinophilie einhergehenden pulmonalen Vaskulitiden werden hinsichtlich ihrer Lungen- und Eosinophilenbeteiligung dargestellt.

Schlüsselwörter

Eosinophile Granulozyten Eosinophilie Vaskulitis Lungenmanifestation Eosinophilenbeteiligung 

Vasculitides and eosinophilic pulmonary diseases

Abstract

Eosinophilic granulocytes form peripheral effector cells controlled by Th2 lymphocytes, which cause local cell, tissue, and functional disorders of infiltrated organs via the release of cytotoxic basic proteins and oxygen radicals. Diseases associated with eosinophilia include systemic and organ-related forms. The lungs are involved in eosinophilic granulomatosis with polyangiitis (EGPA, formerly known as Churg–Strauss syndrome), acute and chronic eosinophilic pneumonia, as well as in an organ manifestation in hypereosinophilic syndrome and certain parasitic diseases. In particular, the lungs are frequently affected in vasculitis of small vessels, including EGPA, granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA). Among these, EGPA is the most frequent pulmonary eosinophil vasculitis representative. In addition, there are various overlap syndromes in which characteristic features of EGPA can be detected in the context of other anti-neutrophil cytoplasmic antibody (ANCA-)associated vasculitides. Occasionally, non-ANCA-associated pulmonary vasculitides occur with eosinophilia (e.g., Schönlein–Henoch purpura, Kawasaki disease, drug-induced hypersensitivity, and paraneoplastic syndrome). Herein, the pulmonary vasculitides accompanying eosinophilia are presented with respect to both the lung manifestations and pulmonary eosinophilia.

Keywords

Eosinophils Eosinophilia Vasculitis Pulmonary manifestation Eosinophil involvement 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

C. Kroegel, M. Foerster, S. Quickert, H. Slevogt und T. Neumann geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • C. Kroegel
    • 1
    Email author
  • M. Foerster
    • 1
  • S. Quickert
    • 2
  • H. Slevogt
    • 3
  • T. Neumann
    • 4
  1. 1.Abt. Pneumologie & Allergologie/Immunologie, Medizinische Klinik IKlinikum der Universität JenaJenaDeutschland
  2. 2.Abt. Gastroenterologie, Hepatologie, Infektiologie, Klinik für Innere Medizin IVUniversitätsklinikum JenaJenaDeutschland
  3. 3.AG Host SeptomicsUniversitätsklinikum JenaJenaDeutschland
  4. 4.Abt. für Rheumatologie, Immunologie und RehabilitationKantonsspital St. GallenSt. GallenSchweiz

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