Biomedical subjects

Francisco P Quismorio

Publications and source records attributed to Francisco P Quismorio.

4 recordsLinked to original sources

PubMed2006

Pulmonary involvement in ankylosing spondylitis.

PURPOSE OF REVIEW: Anti-tumor necrosis factor-alpha agents have recently been approved and recommended as effective and relatively safe drug therapy for ankylosing spondylitis. In light of this major advance in the management of these patients, recent observations on the pulmonary manifestations of ankylosing spondylitis are reviewed. RECENT FINDINGS: High-resolution computed tomography abnormalities were found to be prevalent (range 50-85%) in ankylosing spondylitis even in patients with early disease, and in those with normal chest radiographs and without respiratory symptoms. The high-resolution computed tomography changes included apical fibrosis, interstitial lung disease, emphysema, bronchietasis and pleural thickening. In general, the high-resolution computed tomography changes were of mild degree, and no correlation was observed between high-resolution computed tomography abnormalities, pulmonary function test variables and indices of ankylosing spondylitis symptoms and disease structural severity. Spontaneous pneumothorax was reported to be a rare complication, but tended to occur in those patients with fibrobullous disease. SUMMARY: The clinical significance of the high-resolution computed tomography abnormalities remains to be determined. Most of the published studies are cross-sectional, and are limited by lack of control subjects matched for age, gender and tobacco use. Studies to correlate high-resolution computed tomography changes with bronchoalveolar lavage and lung biopsies as well as prospective studies on long-term evolution of these findings including those patients receiving anti-tumor necrosis factor-alpha agents are needed.

Antirheumatic Agents↗

PubMed2005

Pulmonary involvement in microscopic polyangiitis.

PURPOSE OF REVIEW: Microscopic polyangiitis is a systemic necrotizing vasculitis that affects small vessels, resulting in a wide spectrum of organ involvement including the kidneys and the lungs. This paper reviews recent insights and observations into the pathogenesis, clinical manifestations, and treatment of pulmonary involvement in microscopic polyangiitis. RECENT FINDINGS: The spectrum of clinical presentations ranges from antecedent interstitial fibrosis to frank hemoptysis secondary to capillaritis. Computerized tomography imaging reveals a variety of pulmonary findings, including ground-glass attenuation, consolidation, thickening of bronchovascular bundles, and honeycombing. Antineutrophil cytoplasmic antibodies are important in diagnosis as well as in the pathogenesis and prognosis of microscopic polyangiitis. There is more evidence to support the various therapeutic modalities currently used in pulmonary manifestations of microscopic polyangiitis, including induction therapy with cyclophosphamide, the use of other novel pharmacologic agents such as the tumor necrosis factor-alpha blockers and rituximab, and nonpharmacologic modalities such as plasmapheresis and ventilatory management. SUMMARY: The pulmonary manifestations of microscopic polyangiitis are diverse and often difficult to manage; however, as our understanding and experience grows so does our ability to successfully diagnose and treat these patients.

Antibodies, Antineutrophil Cytoplasmic↗

PubMed2003

Sarcoid arthritis: a review of clinical features, pathology and therapy.

The rheumatic manifestations of sarcoidosis include inflammatory arthritis, periarticular soft tissue swelling, tenosynovitis, dactylitis, bone involvement and myopathy. Two types of arthritis that differ in clinical course and prognosis are recognized. Acute sarcoid arthritis is self-limiting and resolves without permanent sequelae. Chronic sarcoid arthritis although less common can progress to cause joint deformities. There are proliferative and inflammatory changes in the synovium and non-caseating granulomas are seen in half of patients. The pathogenesis of sarcoid arthritis is not well understood, however genetic and environmental factors are important. Drug therapy of sarcoid arthritis with nonsteroidal anti-inflammatory agents, corticosteroids, colchicine, antimalarials and/or immunosuppressive medications is based mainly on open label uncontrolled studies. This review focuses on the current knowledge on the various features of sarcoid arthritis including clinical presentation, course, imaging, and pathology. Recent developments in the usage of anti-tumor necrosis factor therapy for sarcoidosis will be reviewed.

Acute Disease↗

PubMed2003

Inflammatory arthritis secondary to metastatic gastric cancer.

Metastatic spread of malignancy to the joints is rare and only a few cases of solid tumors have been reported. We describe a patient with inflammatory arthritis of the knee and ankle secondary to metastatic gastric adenocarcinoma to the joints and bone diagnosed by synovianalysis. Arthritis secondary to metastatic cancer is a poor prognostic sign. The diagnosis is based on a strong clinical suspicion, magnetic resonance imaging, and joint fluid cytology or synovial biopsy.

Adenocarcinoma↗