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Interdisziplinäre Berührungspunkte zwischen Rheumatologie und Pneumologie

Interdisciplinary point of contact between rheumatology and pneumology

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Zusammenfassung

Die Lunge ist bei vielen entzündlich rheumatischen Erkrankungen am Krankheitsgeschehen beteiligt. Der Beitrag konzentriert sich auf die wichtigsten klinischen Probleme. Bei systemischer Sklerose sind es die interstitielle Lungenkrankheit, die in die Lungenfibrose mündet und die pulmonal arterielle Hypertonie (PAH), die ins Rechtsherzversagen mündet, beim Sjögren-Syndrom sind es die interstitiellen, pleuralen und bronchialen Veränderungen, selten aber auch die PAH, beim Hypereosinophiliesyndrom und dem Churg-Strauss-Syndrom sind es die differenzialdiagnostischen Abgrenzungen gegenüber dem Asthma bronchiale und der allergischen bronchopulmonalen Aspergillose und schließlich bei Patienten mit geplanter TNF-Blocker-Therapie sind es die Tuberkuloseprophylaxe und die adäquaten Tests, die den Rheumatologen und Pneumologen gemeinsam beschäftigen.

Abstract

The lungs are involved in many inflammatory rheumatic diseases. We will focus on the most common clinical problems. In systemic sclerosis interstitial lung disease resulting in fibrosis and pulmonary arterial hypertension (PAH) resulting in right heart failure are the leading complications requiring close cooperation between specialists in rheumatology and pulmonology. In Sjogren’s syndrome interstitial pneumonia, pleural and bronchial inflammation and rarely PAH will be the main pulmonary complications. Hypereosinophilic syndrome, eosinophilic pneumonia, and Churg-Strauss syndrome are conditions that show marked eosinophilia and can clinically be confused with asthma and allergic bronchopulmonary aspergillosis. These conditions mandate thorough investigation of the lungs including bronchoscopy and possibly open lung biopsy. Finally, patients for whom treatment with tumour necrosis factor blocking agents is planned should undergo interdisciplinary management to prevent tuberculosis activation or infection.

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Danksagung

Unser Dank gilt Herrn Prof. Dr. W. Graninger, Rheumatologie, und Herrn Prof. H. Olschewski, Pulmonologie, für die kritische Durchsicht des Manuskripts.

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Authors and Affiliations

  1. Klinische Abteilung für Rheumatologie, Universitätsklinik für Innere Medizin, Auenbruggerplatz 15, 8036, Graz, Österreich

    J. Hermann

  2. Klinische Abteilung für Pulmologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich

    G. Kovacs & S. Scheidl

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  1. J. Hermann
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  2. G. Kovacs
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  3. S. Scheidl
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Correspondence to J. Hermann.

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Hermann, J., Kovacs, G. & Scheidl, S. Interdisziplinäre Berührungspunkte zwischen Rheumatologie und Pneumologie. Z. Rheumatol. 67, 407–414 (2008). https://doi.org/10.1007/s00393-008-0346-x

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