ABSTRACT
La polimiositis es una colagenopatía rara, que puede afectar al pulmón. Entre un 5 y un 30% de los pacientes con polimiositis presenta una enfermedad pulmonar intersticial en el momento del diagnóstico o durante el curso de la enfermedad. El inicio suele ser insidioso en forma de disnea y tos seca. Son varias las entidades histopatológicas que se asocian a polimiositis, de las cuales la más frecuente es la neumonía intersticial no específica. El pronóstico de la enfermedad pulmonar intersticial difusa asociada a polimiositis es mejor que el de la fibrosis pulmonar idiopática, ya que la mayoría de los pacientes responde al tratamiento con glucocorticoides e inmunodepresores. Presentamos el caso clínico de una mujer de 60 años con síntomas de disnea y debilidad muscular, a quien se diagnosticó de polimiositis y enfermedad pulmonar intersticial difusa (posible neumonía intersticial no específica por hallazgos radiológicos), y que mostró buena respuesta al tratamiento con prednisona y metotrexato
Polymyositis is a rare collagen disease that can involve the lungs. Between 5% and 30% of patients with polymyositis present interstitial lung disease at diagnosis or during the course of disease. Onset is usually insidious and involves dyspnea and nonproductive cough. Several histopathological findings are associated with polymyositis and the most common is nonspecific interstitial pneumonia. The prognosis of interstitial lung disease associated with polymyositis is better than that of idiopathic pulmonary fibrosis, since most patients respond to treatment with corticosteroids and immunosuppressants. We report the case of a 60-year-old woman with dyspnea and muscle weakness who was diagnosed with polymyositis and interstitial lung disease (radiography indicated possible nonspecific interstitial pneumonia). The patient responded well to prednisone and methotrexate
Subject(s)
Female , Middle Aged , Humans , Polymyositis/complications , Polymyositis/diagnosis , Glucocorticoids/therapeutic use , Methotrexate/therapeutic use , Pneumonia, Atypical Interstitial, of Cattle/drug therapy , Radiography, Thoracic/methods , Tomography, Emission-Computed/methods , Lung Diseases, Interstitial/complications , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/etiology , Polymyositis/epidemiology , Polymyositis/therapy , Pneumonia, Progressive Interstitial, of Sheep/complications , Lung Diseases, Interstitial/drug therapy , Lung Diseases, Interstitial/epidemiologyABSTRACT
In a blinded multicentre trial 313 cattle showing clinical signs of respiratory disease were allocated randomly into three groups, treated intramuscularly with a long-acting oxytetracycline formulation at a dose rate of 20 mg/kg bodyweight in combination with vehicle alone (placebo) or with tolfenamic acid at 2 mg/kg bodyweight once or on two occasions with a 48-h interdosing interval. The clinical status of the animals was monitored for 5 days using a specific scoring system and weight gain was calculated between day 0 and day 21. Relapses were monitored from day 5 until day 21. When oxytetracycline was combined with two injections of tolfenamic acid, there was a significant (P < 0.04) improvement in the clinical resolution. This regimen also produced non-significant improvements in cure rate, reduced frequency of relapses and improved weight gain.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Cattle Diseases/drug therapy , Oxytetracycline/therapeutic use , Respiratory Tract Diseases/veterinary , ortho-Aminobenzoates/therapeutic use , Animals , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Cattle , Cattle Diseases/microbiology , Double-Blind Method , Drug Therapy, Combination , Evaluation Studies as Topic , Female , Injections, Intramuscular/veterinary , Male , Oxytetracycline/administration & dosage , Pneumonia, Atypical Interstitial, of Cattle/drug therapy , Respiratory Tract Diseases/drug therapy , Respiratory Tract Diseases/microbiology , ortho-Aminobenzoates/administration & dosageSubject(s)
Cattle Diseases/therapy , Respiratory Tract Diseases/veterinary , Animals , Anti-Infective Agents/therapeutic use , Cattle , Cattle Diseases/drug therapy , Cattle Diseases/etiology , Female , Infectious Bovine Rhinotracheitis/prevention & control , Laryngitis/etiology , Laryngitis/therapy , Laryngitis/veterinary , Male , Necrosis/veterinary , Pleurisy/etiology , Pleurisy/prevention & control , Pleurisy/veterinary , Pleuropneumonia, Contagious/etiology , Pleuropneumonia, Contagious/prevention & control , Pneumonia, Atypical Interstitial, of Cattle/drug therapy , Pneumonia, Atypical Interstitial, of Cattle/etiology , Respiratory Tract Diseases/therapyABSTRACT
Nonsteroidal anti-inflammatory drugs inhibit the biosynthesis of kinins and prostaglandins and stabilize leukocyte lysosomal membranes. Nonsteroidal anti-inflammatory drugs also weakly block the biosynthesis of histamine and serotonin, and pharmacologically antagonize kinins, prostaglandins and slow-reacting substance of anaphylaxis. Nonsteroidal anti-inflammatory drugs effectively control both cardiovascular and respiratory manifestations of hypersensitivity in cattle and horses. This, coupled with the contrasting lack of effectiveness of "antiamine" drugs, suggests that bio-amines such as histamine and serotonin (5-hydroxytryptamine) may be less important than kinins, postaglandins and slow-reacting substance in the mediation of the hypersensitivity/inflammatory reaction, at least in cardiopulmonary systems of these species. Nonsteroidal anti-inflammatory drugs justify more prominence in the clinical control of acute respiratory disease in domestic herbivores.
