Interstitial Lung Disease in patients with Polymyalgia Rheumatica: A case series
Introduction: Severe morning stiffness with painful involvement of the girdles are often referred by patients with Interstitial Lung Disease (ILD), but the association between ILD and Polymyalgia Rheumatica (PMR) is rarely reported. The purpose of the work is to describe a series of patients classif...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-01-01
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| Series: | Respiratory Medicine Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007118303253 |
| _version_ | 1819266196731592704 |
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| author | Gianluca Sambataro Domenico Sambataro Francesca Pignataro Sebastiano Emanuele Torrisi Ada Vancheri Mauro Pavone Stefano Palmucci Nicoletta Del Papa Carlo Vancheri |
| author_facet | Gianluca Sambataro Domenico Sambataro Francesca Pignataro Sebastiano Emanuele Torrisi Ada Vancheri Mauro Pavone Stefano Palmucci Nicoletta Del Papa Carlo Vancheri |
| author_sort | Gianluca Sambataro |
| collection | DOAJ |
| description | Introduction: Severe morning stiffness with painful involvement of the girdles are often referred by patients with Interstitial Lung Disease (ILD), but the association between ILD and Polymyalgia Rheumatica (PMR) is rarely reported. The purpose of the work is to describe a series of patients classified as having PMR with ILD. Material and methods: We retrospectively enrolled patients with a diagnosis of PMR referred to our center during the previous year for respiratory symptoms. Data concerning clinical and serological manifestations suggesting Connective Tissue Disease (CTD), High-Resolution Chest Tomography (HRCT), and Pulmonary Function Tests (PFTs) were systematically collected in order to verify the diagnosis. Results: Fifteen out of seventeen PMR patients had ILD. Ten patients had a confirmed diagnosis of PMR, while in five patients a CTD was discovered. Seven patients showed a severe restrictive pattern at PFTs requiring oxygen supplementation (five with PMR and two with CTD). In thirteen patients pulmonary symptoms started before or together with muscular symptoms. Regarding HRCT patterns, patients showed a Nonspecific Interstitial Pneumonia in nine cases, Usual Interstitial Pneumonia (UIP) and possible UIP in two and three cases, and a single case of Organizing Pneumonia and Combined Pulmonary Fibrosis and Emphysema Syndrome. Conclusions: Lung involvement should be evaluated in PMR patients, especially if asthenia is poorly responsive to low doses of steroids. In these cases, the diagnosis should be re-evaluated in depth, looking for a seronegative Rheumatoid Arthritis, a clinically amyopathic myositis or Interstitial Pneumonia with Autoimmune features. Keywords: Interstitial lung disease, Polymyalgia rheumatica, Connective tissue disease, Antisynthetase syndrome, Myositis, Interstitial pneumonia with autoimmune features |
| first_indexed | 2024-12-23T20:57:26Z |
| format | Article |
| id | doaj.art-e1b593d8493644b0a88ff18211f19e67 |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-12-23T20:57:26Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-e1b593d8493644b0a88ff18211f19e672022-12-21T17:31:29ZengElsevierRespiratory Medicine Case Reports2213-00712019-01-0126126130Interstitial Lung Disease in patients with Polymyalgia Rheumatica: A case seriesGianluca Sambataro0Domenico Sambataro1Francesca Pignataro2Sebastiano Emanuele Torrisi3Ada Vancheri4Mauro Pavone5Stefano Palmucci6Nicoletta Del Papa7Carlo Vancheri8Regional Referral Center for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dpt. of Clinical and Experimental Medicine, University of Catania, Italy; Artroreuma S.R.L. Outpatient Clinic Accredited with the National Health System, Corso S. Vito 53, 95030 Mascalucia, CT, Italy; Corresponding author. Regional Referral Center for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dpt. of Clinical and Experimental Medicine, University of Catania, Italy.Artroreuma S.R.L. Outpatient Clinic Accredited with the National Health System, Corso S. Vito 53, 95030 Mascalucia, CT, ItalyDay Hospital of Rheumatology, Dept. of Rheumatology, ASST G. Pini-CTO, Milan, ItalyRegional Referral Center for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dpt. of Clinical and Experimental Medicine, University of Catania, ItalyRegional Referral Center for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dpt. of Clinical and Experimental Medicine, University of Catania, ItalyRegional Referral Center for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dpt. of Clinical and Experimental Medicine, University of Catania, Italy“Policlinico-Vittorio Emanuele”, Dpt. of Radiology, University of Catania, ItalyDay Hospital of Rheumatology, Dept. of Rheumatology, ASST G. Pini-CTO, Milan, ItalyRegional Referral Center for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dpt. of Clinical and Experimental Medicine, University of Catania, ItalyIntroduction: Severe morning stiffness with painful involvement of the girdles are often referred by patients with Interstitial Lung Disease (ILD), but the association between ILD and Polymyalgia Rheumatica (PMR) is rarely reported. The purpose of the work is to describe a series of patients classified as having PMR with ILD. Material and methods: We retrospectively enrolled patients with a diagnosis of PMR referred to our center during the previous year for respiratory symptoms. Data concerning clinical and serological manifestations suggesting Connective Tissue Disease (CTD), High-Resolution Chest Tomography (HRCT), and Pulmonary Function Tests (PFTs) were systematically collected in order to verify the diagnosis. Results: Fifteen out of seventeen PMR patients had ILD. Ten patients had a confirmed diagnosis of PMR, while in five patients a CTD was discovered. Seven patients showed a severe restrictive pattern at PFTs requiring oxygen supplementation (five with PMR and two with CTD). In thirteen patients pulmonary symptoms started before or together with muscular symptoms. Regarding HRCT patterns, patients showed a Nonspecific Interstitial Pneumonia in nine cases, Usual Interstitial Pneumonia (UIP) and possible UIP in two and three cases, and a single case of Organizing Pneumonia and Combined Pulmonary Fibrosis and Emphysema Syndrome. Conclusions: Lung involvement should be evaluated in PMR patients, especially if asthenia is poorly responsive to low doses of steroids. In these cases, the diagnosis should be re-evaluated in depth, looking for a seronegative Rheumatoid Arthritis, a clinically amyopathic myositis or Interstitial Pneumonia with Autoimmune features. Keywords: Interstitial lung disease, Polymyalgia rheumatica, Connective tissue disease, Antisynthetase syndrome, Myositis, Interstitial pneumonia with autoimmune featureshttp://www.sciencedirect.com/science/article/pii/S2213007118303253 |
| spellingShingle | Gianluca Sambataro Domenico Sambataro Francesca Pignataro Sebastiano Emanuele Torrisi Ada Vancheri Mauro Pavone Stefano Palmucci Nicoletta Del Papa Carlo Vancheri Interstitial Lung Disease in patients with Polymyalgia Rheumatica: A case series Respiratory Medicine Case Reports |
| title | Interstitial Lung Disease in patients with Polymyalgia Rheumatica: A case series |
| title_full | Interstitial Lung Disease in patients with Polymyalgia Rheumatica: A case series |
| title_fullStr | Interstitial Lung Disease in patients with Polymyalgia Rheumatica: A case series |
| title_full_unstemmed | Interstitial Lung Disease in patients with Polymyalgia Rheumatica: A case series |
| title_short | Interstitial Lung Disease in patients with Polymyalgia Rheumatica: A case series |
| title_sort | interstitial lung disease in patients with polymyalgia rheumatica a case series |
| url | http://www.sciencedirect.com/science/article/pii/S2213007118303253 |
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