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Damage to the respiratory system in systemic pulmonary vasculitis

Systemic vasculitis (Wegener's granulomatosis, Charge-Strauss syndrome, etc.) is a disease characterized by inflammation and damage to blood vessels.

Pulmonary vasculitis refers to rare pathologies (0.4-14 cases per 100 thousand population per year).

They can develop at any age, but are usually diagnosed in 35-50 years.

The most common lung lesions are Wegener's granulomatosis, eosinophilic granulomatosis with polyangiitis (Charge–Strauss syndrome), microscopic polyangiitis.

The main clinical manifestations of systemic vasculitis:

  • From the respiratory system: cough, shortness of breath, hemoptysis, chest pain, changes in the lungs during X-ray examination
  • Joint damage (arthritis, myalgia, arthralgia)
  • Systemic manifestations (fever, weight loss, weakness)
  • Kidney damage (glomerulonephritis)
  • Lesion of ENT organs (rhinitis, sinusitis, otitis media)

Wegener's granulomatosis is the most common vasculitis of small vessels, more often diagnosed at the age of 40 to 60 years, women and men get sick equally often.

Chronic sinusitis, otitis media, and upper respiratory tract ulcers are often diagnosed. From the side of the lungs, the most frequent manifestations are shortness of breath, hemoptysis, areas of the "frosted glass" type, aseptic decay cavities are recorded on computer tomograms. Kidney damage in the form of glomerulonephritis is characteristic.

Charge-Strauss syndrome (eosinophilic granulomatosis with polyangiitis): men and women are ill, more often diagnosed at the age of 35-50 years.

A triad of syndromes is characteristic:1) bronchial asthma, often severe, uncontrolled course;

2) hypereosinophilia (increased eosinophils) in the blood, sputum, bronchial flushing, BAL;

3) unstable pulmonary infiltrates according to X-ray studies.

It can also affect the upper respiratory tract (usually chronic rhinitis and sinusitis are observed, often nasal polyps). MSCT of the chest organs most often shows unstable ("volatile") areas of “frosted glass” and consolidation.

From other organs and systems: often heart damage (rhythm disturbances, pericarditis), gastrointestinal tract (perforation, ischemia, bleeding), nervous system (myasthenia gravis, mononeuritis, strokes), kidneys (glomerulonephritis).

Microscopic polyangiitis: Usually affects men over the age of 50. Marked systemic symptoms (fever, asthenia, fatigue, malaise, myalgia, arthralgia) are characteristic. Subsequently, rapidly progressing glomerulonephritis develops with the development of renal failure. It is often accompanied by damage to ENT organs (sinusitis, otitis, rhinitis), skin (often in the form of purpura)

Lung damage manifests itself in the form of diffuse alveolar bleeding/capillaritis or fibrosis.

If one or more of these signs are detected, it is recommended to consult a doctor. 

Laboratory tests are carried out for diagnosis: general and biochemical blood tests, rheumo-immunological studies; as well as instrumental studies (examination of the function of external respiration (bodyplethysmography, spirometry, bronchodilation and diffusion tests), multispiral computed tomography, according to indications ultrasound examination of the abdominal cavity, kidneys, joints, heart, esophagogastroduodeoscopy, bronchoscopy with examination bronchoalveolar flushes, lavage, morphological examination of biopsies (according to indications))

In the Moscow Clinical Scientific and Practical Center named after A.S. Loginov, treatment and diagnosis of systemic vasculitis with lung damage is carried out by joint efforts of pulmonologists, ENT, rheumatologists, nephrologists, cardiologists. Do not delay your visit to the specialists of our Center. This will help to diagnose the disease in a timely manner and choose the right treatment tactics. Doctors of GBUZ MCSC named after A.S. Loginov DZM are always ready to help you.

GBUZ Moscow Clinical Scientific Center named after Loginov MHD