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Lungenbeteiligung bei hämatologischen Systemerkrankungen

Lung involvement in hematologic systemic diseases

  • Schwerpunkt: Lunge bei Systemerkrankungen
  • Published:
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Zusammenfassung

Die Lunge kann vom gesamten Spektrum maligner hämatologischer Systemerkrankungen betroffen sein. Obwohl infektiöse Prozesse der Lunge bei diesem immunkompromittierten Patientenkollektiv bekanntermaßen häufig auftreten, sind nichtinfektiologische Ursachen gleichermaßen für pulmonale Veränderungen verantwortlich. Neben den häufigen Infektionen einschließlich opportunistischer Erreger müssen also differenzialdiagnostisch medikamentös induzierte Lungenschädigungen durch zytotoxische Substanzen, Zytokine und neuere Immuntherapeutika, seltener durch Transfusionen von Blutprodukten in Betracht gezogen werden, zudem auch der intrathorakale Befall durch die Grunderkrankung selbst. Schließlich können auch vaskuläre Komplikationen zu pulmonalen Reaktionen führen. Eine frühzeitige und konsequente Diagnostik und Therapie der bronchopulmonalen, intrathorakalen und vaskulären Komplikationen im Rahmen von hämatologischen Systemerkrankungen kann für die Prognose der Patienten essenziell sein.

Abstract

Pulmonary diseases can occur across the entire disease spectrum of malignant hematologic systemic diseases. Although infectious processes of the lungs are common in these immunosuppressed patient collectives, noninfectious causes account for up to half of the pulmonary manifestations found in hematologic malignancies. Besides the frequent infections including opportunistic pathogens, a broad differential diagnosis including drug-induced lung injury by cytostatic substances, cytokines, and innovative immunotherapeutic agents, rarer transfusion of blood products and intrathoracic manifestations of the hematologic malignancy itself, have to be kept in mind. Finally, vascular complications can also lead to pulmonary reactions. Early and consistent diagnostics and treatment of the bronchopulmonary, intrathoracic and vascular complications within the framwework of hematologic systemic diseases can be essential for the patient’s prognosis.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik II, Ludwig-Maximilians Universität München, Campus Großhadern, München, Deutschland

    S.-S. Stecher

  2. Medizinsche Klinik und Poliklinik III, Ludwig-Maximilians Universität München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland

    S. Lippl &  H. J. Stemmler

  3. Universitätsklinik für Pneumologie, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland

    J. Schreiber

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  1. S.-S. Stecher
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Correspondence to H. J. Stemmler.

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Interessenkonflikt

S.-S. Stecher, S. Lippl, H.J. Stemmler und J. Schreiber geben an, dass kein Interessenkonflikt besteht.

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

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W. Hiddemann, München

E. Märker-Hermann, Wiesbaden

C.F. Vogelmeier, Marburg

T. Welte, Hannover

Die Autoren S.-S. Stecher und S. Lippl haben gleichermaßen zum Manuskript beigetragen.

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Stecher, SS., Lippl, S., Stemmler, H.J. et al. Lungenbeteiligung bei hämatologischen Systemerkrankungen. Internist 59, 886–897 (2018). https://doi.org/10.1007/s00108-018-0471-9

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