On these pages you can browse interesting literature on IPF, sarcoidosis, and other ILD.
Sarcoidosis by Robert P. Baughman, Daniel A. Culver, Editors
Sarcoidosis remains a disease of unknown etiology with a variable presentation and clinical outcome.
Despite these limitations, researchers have gained valuable insights into the disease over the past five years.
As editors of this issue, we asked a group of experts in this area to provide timely reviews about various aspects of the disease. We believe the authors have done a tremendous job.
Interobserver agreement for the ATS/ERS/JRS/ALAT criteria for a UIP pattern on CT, by Walsh SL
Is the interobserver agreement for the current ATS/ERS/JRS/ALAT CT criteria for usual interstitial pneumonia (UIP) among radiologists?
What is the bottom line? Interobserver agreement among radiologists for the ATS/ERS/JRS/ALAT criteria for a UIP pattern on CT is moderate.
Why read on? CT plays a critical role in the evaluation of patients with suspected idiopathic pulmonary fibrosis and once performed, significantly
influences subsequent management decisions. Interobserver agreement for the current ATS/ERS/JRS/ALAT CT criteria for UIP is only moderate among thoracic radiologists, irrespective of their experience, and did not vary with patient age or the MDT diagnosis. read more…
New treatment strategies for pulmonary sarcoidosis: antimetabolites, biological drugs, and other treatment approaches, by Baughman RB, and Grutters JC.
About half of patients with sarcoidosis will need systemic therapy for their disease. Oral glucocorticoids are the standard first-line treatment for sarcoidosis. With time, patients might develop substantial morbidity from long-term use of high doses of these drugs. We propose a step-wise approach to the management of pulmonary disease in sarcoidosis and provide details about how and when to use alternatives to glucocorticoids. The antimetabolites, such as methotrexate, azathioprine, leflunomide, and mycophenolate, are often used as alternatives to steroids. For patients who cannot be treated with low-dose glucocorticoids and an antimetabolite, anti-tumour necrosis factor (TNF) monoclonal antibodies have been shown to control disease. Unfortunately, anti-TNF drugs are associated with substantial toxic effects and in some cases are ineffective. The next step in treatment includes new strategies such as rituximab. A new regimen combining four antibiotics (levofloxacin, ethambutol, azithromycin, and rifamycin) has shown some promise in preliminary studies; however, the mechanism of action is unknown. Non-inflammatory effects of sarcoidosis, such as pulmonary hypertension and bronchiectasis, might also contribute to an increase in pulmonary symptoms. In those cases, alternative treatment strategies have to be considered. read more…
Idol Chatter by Om Prakash Sharma, edited by Maggie Sharma
Om Prakash Sharma, MD, FRCP, DTM&H, Master FCCP, FACP, was born in India. After obtaining an MD degree, he read tropical medicine at the London School of Hygiene and Tropical Medicine, London. He served internships in Scotland, and England and a residency at Albert Einstein Medical College, Bronx, New York. read more about Idol chatter…