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Respiratory system involvement in systemic vasculitides.

P Manganelli1, P Fietta, M Carotti

  • 1Dipartimento Osteo-Articolare, Unità Operativa di Reumatologia e Medicina Interna, Azienda Ospedaliera-Universitaria di Parma, Italy.

Clinical and Experimental Rheumatology
|July 25, 2006
PubMed
Summary

The respiratory system is frequently affected in systemic vasculitides (SV), particularly antineutrophil cytoplasmic antibodies-associated vasculitis (AASV). Assessing lung involvement is crucial for diagnosis and prognosis in SV patients.

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Area of Science:

  • Rheumatology
  • Pulmonology
  • Internal Medicine

Background:

  • Systemic vasculitides (SV) can affect the respiratory system with varying frequency.
  • Antineutrophil cytoplasmic antibodies-associated vasculitis (AASV), including Wegener's granulomatosis (WG), Churg-Strauss syndrome (CSS), and microscopic polyangiitis (MPA), commonly involve the lungs.

Purpose of the Study:

  • To review the spectrum of respiratory system involvement in various types of SV.
  • To highlight the clinical and radiological features of pulmonary manifestations in AASV and other SV.
  • To emphasize the importance of respiratory assessment in SV patients.

Main Methods:

  • Review of literature on respiratory involvement in systemic vasculitides.
  • Analysis of clinical presentations and radiological findings in different SV subtypes.

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  • Discussion of diagnostic and prognostic implications of pulmonary manifestations.

    • Main Results:

    • WG frequently presents with upper or lower respiratory tract disease, often showing nodules/masses on chest X-ray.
    • CSS is characterized by asthma and allergic rhinitis, with patchy alveolar infiltrates on imaging.
    • MPA commonly manifests as diffuse alveolar hemorrhage (DAH) due to alveolar capillaritis, presenting with hemoptysis and anemia.
    • Respiratory involvement is less common in giant cell arteritis, Takayasu arteritis, and rare in other SV like polyarteritis nodosa.

    Conclusions:

    • Respiratory system involvement is a significant feature of AASV, with diverse clinical and radiological presentations.
    • Pulmonary manifestations can have prognostic importance in SV.
    • Respiratory assessment should be integral to the work-up of all SV patients, especially those with AASV.