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Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies
Lung involvement, especially interstitial lung disease, is a potentially severe extra-glandular manifestation of Primary Sjogren’s Syndrome (pSS-ILD). ILD can manifest either as a late complication of pSS or anticipate sicca symptoms, likely reflecting two different patho-physiological entities. Pre...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218845/ https://www.ncbi.nlm.nih.gov/pubmed/37240535 http://dx.doi.org/10.3390/jcm12103428 |
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author | La Rocca, Gaetano Ferro, Francesco Sambataro, Gianluca Elefante, Elena Fonzetti, Silvia Fulvio, Giovanni Navarro, Inmaculada C. Mosca, Marta Baldini, Chiara |
author_facet | La Rocca, Gaetano Ferro, Francesco Sambataro, Gianluca Elefante, Elena Fonzetti, Silvia Fulvio, Giovanni Navarro, Inmaculada C. Mosca, Marta Baldini, Chiara |
author_sort | La Rocca, Gaetano |
collection | PubMed |
description | Lung involvement, especially interstitial lung disease, is a potentially severe extra-glandular manifestation of Primary Sjogren’s Syndrome (pSS-ILD). ILD can manifest either as a late complication of pSS or anticipate sicca symptoms, likely reflecting two different patho-physiological entities. Presence of lung involvement in pSS subjects can remain subclinical for a long time; therefore, patients should be actively screened, and lung ultrasound is currently being investigated as a potential low cost, radiation-free, easily repeatable screening tool for detection of ILD. In contrast, rheumatologic evaluation, serology testing, and minor salivary gland biopsy are crucial for the recognition of pSS in apparently idiopathic ILD patients. Whether the HRCT pattern influences prognosis and treatment response in pSS-ILD is not clear; a UIP pattern associated with a worse prognosis in some studies, but not in others. Many aspects of pSS-ILD, including its actual prevalence, association with specific clinical–serological characteristics, and prognosis, are still debated by the current literature, likely due to poor phenotypic stratification of patients in clinical studies. In the present review, we critically discuss these and other clinically relevant “hot topics” in pSS-ILD. More specifically, after a focused discussion, we compiled a list of questions regarding pSS-ILD that, in our opinion, are not easily answered by the available literature. We subsequently tried to formulate adequate answers on the basis of an extensive literature search and our clinical experience. At the same, we highlighted different issues that require further investigation. |
format | Online Article Text |
id | pubmed-10218845 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102188452023-05-27 Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies La Rocca, Gaetano Ferro, Francesco Sambataro, Gianluca Elefante, Elena Fonzetti, Silvia Fulvio, Giovanni Navarro, Inmaculada C. Mosca, Marta Baldini, Chiara J Clin Med Review Lung involvement, especially interstitial lung disease, is a potentially severe extra-glandular manifestation of Primary Sjogren’s Syndrome (pSS-ILD). ILD can manifest either as a late complication of pSS or anticipate sicca symptoms, likely reflecting two different patho-physiological entities. Presence of lung involvement in pSS subjects can remain subclinical for a long time; therefore, patients should be actively screened, and lung ultrasound is currently being investigated as a potential low cost, radiation-free, easily repeatable screening tool for detection of ILD. In contrast, rheumatologic evaluation, serology testing, and minor salivary gland biopsy are crucial for the recognition of pSS in apparently idiopathic ILD patients. Whether the HRCT pattern influences prognosis and treatment response in pSS-ILD is not clear; a UIP pattern associated with a worse prognosis in some studies, but not in others. Many aspects of pSS-ILD, including its actual prevalence, association with specific clinical–serological characteristics, and prognosis, are still debated by the current literature, likely due to poor phenotypic stratification of patients in clinical studies. In the present review, we critically discuss these and other clinically relevant “hot topics” in pSS-ILD. More specifically, after a focused discussion, we compiled a list of questions regarding pSS-ILD that, in our opinion, are not easily answered by the available literature. We subsequently tried to formulate adequate answers on the basis of an extensive literature search and our clinical experience. At the same, we highlighted different issues that require further investigation. MDPI 2023-05-12 /pmc/articles/PMC10218845/ /pubmed/37240535 http://dx.doi.org/10.3390/jcm12103428 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review La Rocca, Gaetano Ferro, Francesco Sambataro, Gianluca Elefante, Elena Fonzetti, Silvia Fulvio, Giovanni Navarro, Inmaculada C. Mosca, Marta Baldini, Chiara Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies |
title | Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies |
title_full | Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies |
title_fullStr | Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies |
title_full_unstemmed | Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies |
title_short | Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies |
title_sort | primary-sjögren’s-syndrome-related interstitial lung disease: a clinical review discussing current controversies |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218845/ https://www.ncbi.nlm.nih.gov/pubmed/37240535 http://dx.doi.org/10.3390/jcm12103428 |
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