A large number of drugs are now used to treat systemic autoimmune diseases. These include cytotoxic drugs, antimetabolites, antimalarial agents, gold, penicillamine, nonsteroidal anti-inflammatory drugs (NSAIDs), antihyperuricemic drugs, and immune modulators, such as corticosteroids and cyclosporin. In the last few decades, it has been recognized that many of these agents cause pulmonary toxic manifestations. Recognition of a respiratory complication in a patient with a systemic autoimmune disease as being caused by drug toxicity rather than other causes can be problematic. First, these disorders themselves involve the lung in patterns that can be indistinguishable from drug toxicity. Bronchospasm, pleural effusions, pulmonary infiltrates with eosinophilia, interstitial pneumonitis, and pulmonary fibrosis can all be manifestations of drug toxicity or the underlying autoimmune disease. From a histopathologic viewpoint, the lung tends to respond to injury in a limited number of ways, so that there are no pathologic findings that are pathognomonic of antirheumatic drug toxicity. Similarly, radiologic and pulmonary function findings of drug toxicity are often nonspecific. Additionally, in systemic autoimmune disorders, particularly in rheumatoid arthritis (RA), it is common to use more than one disease-modifying agent at a time, and therefore, even if drug toxicity is suspected it may be difficult to ascertain the precise offending agent. Recognition of pulmonary toxicity of antirheumatic drugs then depends on a careful clinical assessment and requires knowledge of the manifestations of the underlying rheumatologic disorder and the type and time course of pulmonary toxicity associated with the antirheumatic drugs being used. This article reviews the most important of the antirheumatic drug-related pulmonary complications, discusses difficulties with their diagnosis, and where known, gives proposed mechanisms of toxicity.

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   |wiki=    Sante
   |area=    ChloroquineV1
   |flux=    Main
   |étape=   Exploration
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   |clé=     ISTEX:7052B35C605A66D89EA33CD3BB8772E88F1A0797
   |texte=   PULMONARY TOXICITY OF DRUGS USED TO TREAT SYSTEMIC AUTOIMMUNE DISEASES
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