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„Enthusiast meets the Experienced“: Pneumo meets … Rheumatologie

Enthusiast meets the experienced: pneumo meets … rheumatology

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  • Published:
Zeitschrift für Pneumologie Aims and scope

Zusammenfassung

Eine Vielzahl komplexer pulmonaler Krankheitsbilder erfordert eine enge Zusammenarbeit zwischen PneumologIn und RheumatologIn. So kann nahezu jede rheumatische Systemerkrankung mit einer interstitiellen Lungenerkrankung einhergehen („connective tissue disease-related interstitial lung disease“ [CTD-ILD]). Dies verschlechtert die Prognose häufig deutlich. Sowohl im Rahmen des diagnostischen Prozesses, insbesondere bei der Abgrenzung von Medikamententoxizitäten, als auch bei Therapieentscheidungen sind PneumologInnen und RheumatologInnen gemeinsam gefragt. Gleiches gilt für verschiedene indirekte Mitbeteiligungen von Lunge und Pleura bei Patienten mit rheumatischen Erkrankungen. Rundherde und Pleuraergüsse treten häufig auf, ihre diagnostisch-therapeutische Einordnung kann jedoch herausfordernd sein. Auch Lungenarterienembolien können bei bestimmten Krankheitsbildern wie dem Antiphospholipidantikörpersyndrom (APS) und Morbus Behçet häufiger auftreten. Teils schwere Bronchopathien sind besonders häufig bei der rheumatoiden Arthritis, rezidivierender Polychondritis (RP) und der Granulomatose mit Polyangiitis (GPA). Auch eine pulmonale Hypertonie kann bei verschiedenen Erkrankungen aus dem rheumatischen Formenkreis auftreten. Eine Einteilung in eine der 5 Gruppen ist hierbei therapeutisch bedeutsam.

Abstract

Many complex pulmonary diseases require close cooperation between pneumologists and rheumatologists. For example, almost every rheumatic systemic disease can be accompanied by connective tissue disease-associated interstitial lung disease (CTD-ILD). This often significantly negatively affects the prognosis. Pneumologists and rheumatologists are jointly called upon in the diagnostic process, especially in the delineation of drug toxicities and in therapeutic decisions. The same applies to various indirect forms of involvement of the lungs and pleura in patients with rheumatic diseases. Nodules and pleural effusions frequently occur but the diagnostic and therapeutic classification can be challenging. Pulmonary artery embolisms can also occur more frequently in certain diseases, such as in antiphospholipid antibody syndrome (APS) and Behçet’s disease. Sometimes severe bronchopathy develops in rheumatoid arthritis, recurrent polychondritis (RP) and granulomatosis with polyangiitis (GPA). Pulmonary hypertension can also occur in various rheumatic diseases and the classification into one of the five groups is therapeutically important.

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Authors and Affiliations

  1. Zentrum für seltene und interstitielle Lungenerkrankungen, Thoraxklinik, Universitätsklinikum Heidelberg und Deutsches Zentrum für Lungenforschung (DZL) – Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland

    Katharina Buschulte & Michael Kreuter

  2. Klinik für Pneumologie, Klinikum Ludwigsburg, Ludwigsburg, Deutschland

    Michael Kreuter

  3. Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin, Berlin, Deutschland

    Udo Schneider & Vincent Casteleyn

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  1. Katharina Buschulte
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  4. Vincent Casteleyn
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Correspondence to Katharina Buschulte.

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Interessenkonflikt

K. Buschulte erhielt ein Vortragshonorar von Boehringer Ingelheim. M. Kreuter erhielt von Roche und Boehringer Ingelheim Grants und Vergütungen für Beratungstätigkeiten. U. Schneider erhielt Vortrags- und Beraterhonorare von Boehringer Ingelheim. V. Casteleyn gibt an, dass kein Interessenkonflikt besteht.

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J. Wälscher, Essen

C. Fisser, Regensburg

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Buschulte, K., Kreuter, M., Schneider, U. et al. „Enthusiast meets the Experienced“: Pneumo meets … Rheumatologie. Z Pneumologie 20, 20–32 (2023). https://doi.org/10.1007/s10405-022-00483-9

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