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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Lung involvement in inflammatory rheumatic diseases.

Clive Kelly1, Kundan Iqbal1, La'ali Iman-Gutierrez1

  • 1Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE9 6SX, UK.

Best Practice & Research. Clinical Rheumatology
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Summary

This chapter details lung complications in systemic inflammatory joint diseases (IJD), focusing on rheumatoid arthritis. It covers interstitial lung disease, airway disease, infections, and pleural issues, alongside therapeutic advances for IJD patients.

Keywords:
Ankylosing spondylitisBronchiectasisDrug-induced lung diseaseFibrosisInfectionLung diseasePleural diseasePsoriatic arthritisRheumatoid arthritis

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Area of Science:

  • Rheumatology
  • Pulmonology
  • Immunology

Background:

  • Systemic inflammatory joint diseases (IJD) like rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis have significant pulmonary manifestations.
  • Pulmonary complications represent a major cause of morbidity and mortality in patients with IJD.

Purpose of the Study:

  • To provide a comprehensive overview of lung involvement in IJD.
  • To highlight recent advances in understanding and managing interstitial lung disease, airway disease, infections, and pleural disease associated with IJD.
  • To review the impact of IJD therapies on pulmonary health.

Main Methods:

  • Literature review focusing on recent advances in IJD and pulmonary complications.
  • Synthesis of information on interstitial lung disease, airway disease (including bronchiectasis), acute pulmonary infections, and pleural disease.
  • Analysis of the relationship between IJD drug therapies and lung effects.

Main Results:

  • Interstitial lung disease is the most lethal pulmonary complication, with recent therapeutic advances offering improved outcomes.
  • Airway disease, including bronchiectasis, is equally common and increasingly recognized in IJD.
  • Acute pulmonary infections and pleural disease are also significant concerns, with updated management strategies discussed.

Conclusions:

  • Lung involvement is a critical, often under-recognized aspect of IJD.
  • Advances in understanding and treatment offer hope for better management of pulmonary complications in IJD.
  • The interplay between IJD treatments and lung health requires careful consideration.