Il suono delle ILDs fibrosanti

Un approfondimento interattivo sull’identificazione del suono «velcro-like» nella diagnosi precoce di ILDs fibrosanti

L’individuazione precoce è un fattore critico nelle ILDs fibrosanti. Infatti, i pazienti con fibrosi polmonare in fasi iniziali sono spesso asintomatici e non riportano sintomi specifici.

Per questo motivo, un’approfondita auscultazione polmonare e la giusta identificazione dei suoni «velcro-like», possono fare la differenza nell’individuazione precoce di ILDs fibrosanti.

In questo contenuto interattivo, è possibile ascoltare il caratteristico suono «velcro-like» presente all’auscultazione di quattro pazienti con ILD fibrosante. Sono inoltre disponibili per l’ascolto anche due esempi di suoni tratti dall’auscultazione di due pazienti con BPCO, come supporto ad una corretta identificazione differenziale.

01cHome   3

 

 

bottone fibrosi1a

 

File audio
bottone fibrosi2

 

File audio
bottone fibrosi3

 

File audio
bottone fibrosi4

 

File audio
bottone COPD1

 

File audio
bottone COPD2

 

File audio

References

 

  1. Cottin V, Hirani NA, Hotchkin DL, et al. Presentation, diagnosis and clinical course of the spectrum of progressive fibrosing interstitial lung diseases. Eur Respir Rev. 2018;27(150):180076. doi: 10.1183/16000617.0076–2018.
  2. Hoffmann-Vold AM, Fretheim H, Halse AK, et al. Tracking impact of interstitial lung disease in systemic sclerosis in a complete nationwide cohort. Am J Respir Crit Care Med. 2019;200;1258–1266.
  3. Solomon JJ, Danoff SK, Goldberg HJ, et al. The design and rationale of the Trail1 trial: a randomized double-blind phase 2 clinical trial of pirfenidone in rheumatoid arthritis associated interstitial lung disease. Adv Ther. 2019;36(11):3279–3287.
  4. Olson AL, Swigris JJ, Sprunger DB, et al. Rheumatoid arthritis-interstitial lung disease-associated mortality. Am J Respir Crit Care Med. 2011;183:372–378.
  5. Geerts S, Wuyts W, de Langhe E, et al. Connective tissue disease associated interstital pneumonia: a challenge for both rheumatologists and pulmonologists. Sarcoidosis Vasc Dif. 2017;34:326–335.
  6. Esposito AJ, Chu SG, Madan R, et al. Thoracic manifestations of rheumatoid arthritis. Clin Chest Med. 2019;40(3):545–560.
  7. Shaw M, Collins BF, Ho LA, Raghu G. Rheumatoid arthritis-associated lung disease. Eur Respir Rev. 2015;24(135):1–16.
  8. Kelly CA, Saravanan V, Nisar M, et al. Rheumatoid arthritis-related interstitial lung disease: associations, prognostic factors and physiological and radiological characteristics – a large multicentre UK study. Rheumatology (Oxford). 2014;53(9):1676–1682.
  9. Tyndall AJ, Bannert B, Vonk M, et al. Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. Ann Rheum Dis. 2010;69(10):1809-1815. doi:10.1136/ ard.2009.114264.
  10. Cassone G, Manfredi A, Vacchi C, et al. Treatment of rheumatoid arthritis-associated interstitial lung disease: lights and shadows. J Clin Med. 2020;9(4):1082.
  11. Spagnolo P, Cordier JF, Cottin V. Connective tissue diseases, multimorbidity and the ageing lung. Eur Respir J. 2016;47(5):1535–1558.
  12. Castelino FV, Moua T. Detection and management of interstitial lung diseases associated with connective tissue diseases. ACR Open Rheumatol. 2021;3(5):295-304.
  13. Volkmann ER, Tashkin DP. Treatment of systemic sclerosis-related interstitial lung disease: a review of existing and emerging therapies. Ann Am Thorac Soc. 2016;13(11):2045–2056.
  14. Perelas A, Silver RM, Arrossi AV, et al. Systemic sclerosis-associated interstitial lung disease. Lancet Respir Med. 2020;8:304–320.
  15. Swigris JJ, Yorke JY, Sprunger DB, et al. Assessing dyspnea and its impact on patients with connective tissue disease-related interstitial lung disease. Respir Med. 2010;104: 1350–1355.
  16. Lee AS, Scofield RH, Hammitt KM, et al. Consensus guidelines for evaluation and management of pulmonary disease in Sjögren’s. Chest. 2021;159(2):683–698.
  17. Sgalla G, Walsh SLF, Sverzellati N, et al. “Velcro-type” crackles predict specific radiologic features of fibrotic interstitial lung disease. BMC Pulm Med. 2018;18(1):103.
  18. Cottin V, Cordier J. Velcro crackles: the key for early diagnosis of idiopathic pulmonary fibrosis? Eur Respir J. 2012;40(3):519–521.
  19. Lake F, Proudman S. Rheumatoid arthritis and lung disease: from mechanisms to a practical approach. Semin Respir Crit Care Med. 2014;35(2):222–238.
  20. Mecoli C, Christopher-Stine L. Management of interstitial lung disease in patients with myositis specific autoantibodies. Curr Rheumatol Rep. 2018;20(5):27.
  21. Wallace B, Vummidi D, Khanna D. Management of connective tissue diseases associated interstitial lung disease: a review of the published literature. Curr Opin Rheumatol. 2016;28(3):236–245.
  22. Baughman RP, Shipley RT, Loudon RG, et al. Crackles in interstitial lung disease. Comparison of sarcoidosis and fibrosing alveolitis. Chest. 1991; 100: 96–101.

ARTICOLI CORRELATI

LEGGI
img-card
PRATICA CLINICA

Come richiedere un’HRCT nel sospetto clinico di ILD

Video pillola a cura della Dott.ssa Valentina Vespro, UOC Radiologia - Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano
LEGGI
img-card
PRATICA CLINICA

IPF e PPF: le linee guida ufficiali di pratica clinica ATS/ERS/JRS/ALAT

Le nuove linee guida ATS/ERS/JRS/ALAT illustrate in uno slide deck
LEGGI
img-card
APPROFONDIMENTI

Malattie del tessuto connettivo associate ad ILD (CTD-ILD)

Visual Thinking sul ruolo del team multidisciplinare nel percorso dei pazienti con CTD-ILD