Immunology and allergy clinics of North America
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This article provides a broad overview of the complex intersection between the connective tissue diseases (CTDs) and their pulmonary manifestations. Indirect pulmonary complications - such as respiratory infection and medication-induced lung toxicity - are briefly discussed, and the importance of a comprehensive assessment of the patient with CTD with respiratory symptoms is emphasized. A concise review of the many pulmonary manifestations of each specific CTD is provided, and particular emphasis is placed on CTD-associated interstitial lung disease.
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Sarcoidosis is a multisystem granulomatous syndrome with a vast range of clinical manifestations. Since the first description of sarcoidosis in 1869, it has simultaneously intrigued and perplexed generations of physicians. ⋯ Medication is considered when there is risk of irreversible vital organ damage, substantial progression, or symptoms that are affecting quality of life. Recently, a range of steroid-sparing therapies have been adopted for sarcoidosis.
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Immunol Allergy Clin North Am · Nov 2012
ReviewUpdate on diffuse alveolar hemorrhage and pulmonary vasculitis.
Diffuse alveolar hemorrhage is a clinical syndrome that can be a manifestation of multiple different causes. Identification of the underlying etiology is of utmost importance and dictates treatment. ⋯ For AAV, treatment includes induction followed by maintenance therapy. Rituximab has an increasing role in the treatment of AAV.
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Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease of unknown cause characterized by progressive scarring of the lung parenchyma and relentless loss of lung function. The diagnosis depends on close collaboration between clinicians, radiologists, and pathologists. No therapies approved by the Food and Drug Administration are available for IPF, and an analysis of completed clinical trials has demonstrated that the clinical course of IPF is largely unpredictable. Until therapies that improve survival become available, measures to preserve function and quality of life should be considered, and gastroesophageal reflux should be treated aggressively.